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Eremophila decipiens
Year 2024, Issue 3, Article 4CaseAuthor: Jan Scholten
Man, 26, Multiple sclerosis.
For 3 years, worse last 3 months.
Walking is difficult, balance is difficult, needing crutches when walking more than a few hundred meters.
Spasticity of the right leg.
Vision double, intermittent, < looking to the right side.
Urge to urinate frequently.CreativityDesire to write, a creative value to explore.
Creativity is important.
Music is important, played guitar in a heavy metal band.
Their first album never was out since 3 years, because the singer left when the CD was almost ready.
The CD is in the process of being worked out, still not out, is okay, not emotionally attached to the band.
Not playing guitar, < lack of motivation, < playing compromised by MS.
I always second fiddle, never in control, < unsure of myself, < fear being criticised.State of beingSitting home, doing nothing the rest of my life.
Statue mode, which is bringing down general well being.
Lack of motivation, to anything, is an obstacle to getting better, slipping into lazy mode.
Not bothered about anything.
DepressedYouthHappy go lucky child.
Father: very similar, great contact, healthy open dialogues.
Mother: really good relationship, homeopathy, neurologist.
Sister, fantastic, but became a hell raiser in puberty.
Puberty: nice guy, averse creating problems.Consultation 4Patient: I know my friends and my friends don't like this, but I imagine their discomfort, I actualise their and it is just not a fun social environment.
There yeah well True Hi there
Doctor: do you have to be fun, otherwise they like you?
Patient: yeah air yeah very well, I mean, I suppose I don't have to be fun, there are but I catch myself talking about stuff that is inappropriate. When I say inappropriate I mean too heavy. My friends don't want to talk on Saturday night about the underlying truth of reality, or consciousness, or about how everyone is distracting themselves from really important stuff. Because they don't need to think about that stuff, especially on a Saturday night, but recently I have been in a place where that is all I care about. So, maybe I don't want to hang around with my friends as I imagine they want to hang out with me, because what they care about. They are wrapped up in insignificant, irrelevant life. They hold to dear to these things they have accomplished, that is not even a conversation. Basically we live on different levels, my friends and I.
Doctor: What is the problem then.
Patient: because I am super envious about their not having to care about what they eat, where they are gonna stay, and they are all on a path, in some way, my friends, where as I am stationary.
Doctor: you are also on a path.
Patient: yeah, yeah yeah, it is not a path that helps me align with my friends. My friends can only see my situation from a third person point of view.
Doctor: what is the problem of it? They see things as they see it, that is it. What is bothering you?
Patient: what is bothering me?
Doctor: you put yourself that you cannot go out with your friends, but you don't even want to.
Patient: yeah, yeah, that's true. I was so much closer to these people. It was such a natural closeness with my friends, and it was with out effort, the friendship just flowed. And now a new variable, a new element has been introduced to our friendships, and to me that is toxic. I think that people are thinking about my situation a lot more time than they actually do. But to me the friendships are now not natural, unnatural. Because, I'm thinking of a particular group of friends, some of my best friends I was in a band with, we played music for years and now I am not playing guitar, so now I cannot play also because I'm not bothered playing, I suppose if I was less lazy, more getting up and go, may be less depressed, I would so be more interested in playing guitar again, but I haven't played for so long and my hands have gone so slow and these are things then it don't bother me as they would my friends. I think a big part in the break of our relationship, the crack, has turned for them into a piteous thing, where they feel obliged to be my friend, (burping) because these friendship have lasted for 10 years or more. Sometimes I feel as though I don't want to be here, you guys don't want me to be here, you guys just have me around because you feel bad for me, you know me I am a nice guy who deserves friends, you oblige me.
Doctor: do you discuss it with them?
Patient: yeah, once or twice. And the guys are full of positive reinforcement.
Doctor: but you don't believe them.
Patient: yeah, I don’t believe them because it just seems such a big ask for them to just say “oh yeah, the MS, it just doesn't matter, just come by, we are all mates, we all just want to hangout with each other, we all friends”. It is hard for me to see then to see the MS as no big deal, you know. Because it is obviously a big deal in my life. I cannot help but feel as though my friends share those feelings. But I don't know, I don't know. I am feeling socially anxious as a result of al this. I am so glad that this path has come to this point, because it only ever seemed like it was going to be a path that dealt with physical disabilities, but that has been kind of dealt with, not totally, obviously not totally, but I'm feeling more grounded physically, even if it's not improvement, but the main issue or one of the main issues seems to me my mental state.
Doctor: But I still don't understand, you know, you said you don't believe them that they want to hang out with you, but on the other hand you don't want, so what is bothering you? What makes you depressed? You miss your friends?
Patient: I know I can hang out with my friends, at pretty short notice. I guess what I simply want is to go back to life, before all this mess.
Doctor: Could you do that? Suppose the MS disappears now, could you go back to the same life?
Patient: I cannot even begin to think what that might be like. Because I wonder if I would play guitar again, what kind of job I would get in. If I think about it enough, I wonder what my friendships would be like.
Doctor: Suppose your MS disappears gets over, is healed tomorrow, what would your friendships be then? How would you act, what would you do?
Patient: yeah, it would be much the same, I would be more able to go nights out, or I feel able. I'm starting to realise that there is a difference between being able and feeling able. Right now I'm feeling I'm not able to do a lot of things.
Doctor: I'm asking you because you have told that you're interested in things that they are not interested in.
Patient: what they are interested in is what every 20-year-old person is interested in, and that is buying expensive stuff. Ahhhh, my friends are not overly materialistic. I just see the shortcomings in my friends from time to time, it might be the result of just being depressed, selfish. I don't know, I think I make a lot of the stuff up, like in my own head. I spend a lot of my time up in my room my and my thoughts just run away. It seems as though it is just an anxiety. I don't like to hangout with my friends because I have nothing to say to them, because my life is in statue mode. My friends, like I said, are on a path, I agree I am also on a path, but that path does not interest my friends. They want me to be happy but they don't need to know why I am happy. Because, the reason, I am getting interested in eastern philosophy. The stuff that I am learning about focuses on not identifying yourself as a person, as your body, your job, your girlfriend, whatever it may be. My friends don't need to think about that crap, whereas I like to think about that stuff because I think it is true, and it makes the MS going into the background, it is not the main thing, from this point of view, the point of view of these philosophers. Nothing is important. After a talking a few times with friends about these things they made it clear that it was not good dinner conversation.
Doctor: how did you feel when they said like that?
Patient: what actually happened was that we had a conversation, and then I went home, and
the next time I talked with that guy I had realised that we should know should not have talked about that stuff, because you are at place in your life where you have to sort out your band, job, girls, all that stuff, and then I came along and told you it was all a dream, it was all illusory, so of course, I understand that people don't want to hear of these things.
Doctor: what does that do that to you, when they don't want to hear about these things?
Patient: I kind of feel apologetic, I feel as if I don't want to step on your toes, but sometimes it feels as if I have to talk about it. But I understand that they don't want to talk about it. I don't want to talk about it to people that don't want to hear it.
Doctor: but is your depression a kind of loss of friends? Because it is difficult to have contact again? You are on a different level, you are on a different subject, on different thing.
Patient: I don't know, is it as so simple as that?
Doctor: You can keep them as friends, but you cannot expect what you need, maybe you have to find some other friends.
Patient: yeah, of course. I came to that conclusion when I talked with that friend and he literally said during the conversation “I don’t need that stuff, I don’t need that in my life”, he did not say it so that I could get to sleep. He made it apparent that it wasn't needed and that “If you need that is all good, so let us talk about something else”.
Doctor: so you cannot meet them on that level.
Patient: no, I actually can't, I fall short of their level, but I am way there on a different level, but their level is here.
Doctor: their level. So what is the problem, that’s the point, what makes you depressed? Is it a kind of grief, of loss of friends? What is going on in you, what makes you depressed? It is better to look at yourself then looking at them.
Patient: definitely. Apart from restrictions caused by multiple sclerosis, because that is a thing, it feels that it is definitely a driving force to my depression. Apart from that it is about how I am useless socially, with this group of friends in particular I cannot get on a level with them, hanging out never feels comfortable, and when it's uncomfortable I am just thinking why I am not being comfortable, and I think about that until the next time I see them, and then I think a lot of the time, thinking about why it was uncomfortable with them.Follow up after 2 yearsPatient: yes, I am doing very well. I have been able to move on, move in back with my girlfriend. I have had a few jobs since the first consultation and I am presently working for IBM in some IT, maintenance, server thing. I'm doing that the last six months. I don't need a walking stick, I am asymptomatic. I think all in all life has taken a sharp 180° turn. I feel, even when I'm tired at the end of the day: good. It is like night and day compared to the first consultation. Life has been treating me well, better then it has been doing the years before.
Doctor: dear have any symptoms left of the multiple sclerosis?
Patient: there is a slight insensitivity in the fingers of my left-hand, the sensitivity ether is not hundred percent, but that has been since the time of the first diagnosis. Further no symptoms, no double vision. It seemed that everything was wrong at a certain point, but now I am operating perfectly fine, and very well. I have a sincere appreciation of What you're done for me.
Doctor: what score would you give yourself on quality of life?
Patient: even when I'm asymptomatic, I feel that's the last three years have Had an impact on me socially, so I was very withdrawn from social situations for a very long time and I think I'm still recovering from that little bit. So taking that into consideration I want to give myself an 80. If you can't be in the midst of being out with friends I would see 85, 90. I really feel I'm living a life is good, multiple sclerosis why is as good as as I could possibly hope for
Doctor: what score would you have give yourself before on quality of life?
Patient: Less than 40, probably 20. It is so relative, it could have been much worse with me. Initially when I first saw you, my life was ripped upside down. I would have scored myself very low, maybe 20. I was not happy, very unhappy. That's not my life right now. The remedies have done a tremendous job. I'm not taking any medicines that moment.
For 3 years, worse last 3 months.
Walking is difficult, balance is difficult, needing crutches when walking more than a few hundred meters.
Spasticity of the right leg.
Vision double, intermittent, < looking to the right side.
Urge to urinate frequently.CreativityDesire to write, a creative value to explore.
Creativity is important.
Music is important, played guitar in a heavy metal band.
Their first album never was out since 3 years, because the singer left when the CD was almost ready.
The CD is in the process of being worked out, still not out, is okay, not emotionally attached to the band.
Not playing guitar, < lack of motivation, < playing compromised by MS.
I always second fiddle, never in control, < unsure of myself, < fear being criticised.State of beingSitting home, doing nothing the rest of my life.
Statue mode, which is bringing down general well being.
Lack of motivation, to anything, is an obstacle to getting better, slipping into lazy mode.
Not bothered about anything.
DepressedYouthHappy go lucky child.
Father: very similar, great contact, healthy open dialogues.
Mother: really good relationship, homeopathy, neurologist.
Sister, fantastic, but became a hell raiser in puberty.
Puberty: nice guy, averse creating problems.Consultation 4Patient: I know my friends and my friends don't like this, but I imagine their discomfort, I actualise their and it is just not a fun social environment.
There yeah well True Hi there
Doctor: do you have to be fun, otherwise they like you?
Patient: yeah air yeah very well, I mean, I suppose I don't have to be fun, there are but I catch myself talking about stuff that is inappropriate. When I say inappropriate I mean too heavy. My friends don't want to talk on Saturday night about the underlying truth of reality, or consciousness, or about how everyone is distracting themselves from really important stuff. Because they don't need to think about that stuff, especially on a Saturday night, but recently I have been in a place where that is all I care about. So, maybe I don't want to hang around with my friends as I imagine they want to hang out with me, because what they care about. They are wrapped up in insignificant, irrelevant life. They hold to dear to these things they have accomplished, that is not even a conversation. Basically we live on different levels, my friends and I.
Doctor: What is the problem then.
Patient: because I am super envious about their not having to care about what they eat, where they are gonna stay, and they are all on a path, in some way, my friends, where as I am stationary.
Doctor: you are also on a path.
Patient: yeah, yeah yeah, it is not a path that helps me align with my friends. My friends can only see my situation from a third person point of view.
Doctor: what is the problem of it? They see things as they see it, that is it. What is bothering you?
Patient: what is bothering me?
Doctor: you put yourself that you cannot go out with your friends, but you don't even want to.
Patient: yeah, yeah, that's true. I was so much closer to these people. It was such a natural closeness with my friends, and it was with out effort, the friendship just flowed. And now a new variable, a new element has been introduced to our friendships, and to me that is toxic. I think that people are thinking about my situation a lot more time than they actually do. But to me the friendships are now not natural, unnatural. Because, I'm thinking of a particular group of friends, some of my best friends I was in a band with, we played music for years and now I am not playing guitar, so now I cannot play also because I'm not bothered playing, I suppose if I was less lazy, more getting up and go, may be less depressed, I would so be more interested in playing guitar again, but I haven't played for so long and my hands have gone so slow and these are things then it don't bother me as they would my friends. I think a big part in the break of our relationship, the crack, has turned for them into a piteous thing, where they feel obliged to be my friend, (burping) because these friendship have lasted for 10 years or more. Sometimes I feel as though I don't want to be here, you guys don't want me to be here, you guys just have me around because you feel bad for me, you know me I am a nice guy who deserves friends, you oblige me.
Doctor: do you discuss it with them?
Patient: yeah, once or twice. And the guys are full of positive reinforcement.
Doctor: but you don't believe them.
Patient: yeah, I don’t believe them because it just seems such a big ask for them to just say “oh yeah, the MS, it just doesn't matter, just come by, we are all mates, we all just want to hangout with each other, we all friends”. It is hard for me to see then to see the MS as no big deal, you know. Because it is obviously a big deal in my life. I cannot help but feel as though my friends share those feelings. But I don't know, I don't know. I am feeling socially anxious as a result of al this. I am so glad that this path has come to this point, because it only ever seemed like it was going to be a path that dealt with physical disabilities, but that has been kind of dealt with, not totally, obviously not totally, but I'm feeling more grounded physically, even if it's not improvement, but the main issue or one of the main issues seems to me my mental state.
Doctor: But I still don't understand, you know, you said you don't believe them that they want to hang out with you, but on the other hand you don't want, so what is bothering you? What makes you depressed? You miss your friends?
Patient: I know I can hang out with my friends, at pretty short notice. I guess what I simply want is to go back to life, before all this mess.
Doctor: Could you do that? Suppose the MS disappears now, could you go back to the same life?
Patient: I cannot even begin to think what that might be like. Because I wonder if I would play guitar again, what kind of job I would get in. If I think about it enough, I wonder what my friendships would be like.
Doctor: Suppose your MS disappears gets over, is healed tomorrow, what would your friendships be then? How would you act, what would you do?
Patient: yeah, it would be much the same, I would be more able to go nights out, or I feel able. I'm starting to realise that there is a difference between being able and feeling able. Right now I'm feeling I'm not able to do a lot of things.
Doctor: I'm asking you because you have told that you're interested in things that they are not interested in.
Patient: what they are interested in is what every 20-year-old person is interested in, and that is buying expensive stuff. Ahhhh, my friends are not overly materialistic. I just see the shortcomings in my friends from time to time, it might be the result of just being depressed, selfish. I don't know, I think I make a lot of the stuff up, like in my own head. I spend a lot of my time up in my room my and my thoughts just run away. It seems as though it is just an anxiety. I don't like to hangout with my friends because I have nothing to say to them, because my life is in statue mode. My friends, like I said, are on a path, I agree I am also on a path, but that path does not interest my friends. They want me to be happy but they don't need to know why I am happy. Because, the reason, I am getting interested in eastern philosophy. The stuff that I am learning about focuses on not identifying yourself as a person, as your body, your job, your girlfriend, whatever it may be. My friends don't need to think about that crap, whereas I like to think about that stuff because I think it is true, and it makes the MS going into the background, it is not the main thing, from this point of view, the point of view of these philosophers. Nothing is important. After a talking a few times with friends about these things they made it clear that it was not good dinner conversation.
Doctor: how did you feel when they said like that?
Patient: what actually happened was that we had a conversation, and then I went home, and
the next time I talked with that guy I had realised that we should know should not have talked about that stuff, because you are at place in your life where you have to sort out your band, job, girls, all that stuff, and then I came along and told you it was all a dream, it was all illusory, so of course, I understand that people don't want to hear of these things.
Doctor: what does that do that to you, when they don't want to hear about these things?
Patient: I kind of feel apologetic, I feel as if I don't want to step on your toes, but sometimes it feels as if I have to talk about it. But I understand that they don't want to talk about it. I don't want to talk about it to people that don't want to hear it.
Doctor: but is your depression a kind of loss of friends? Because it is difficult to have contact again? You are on a different level, you are on a different subject, on different thing.
Patient: I don't know, is it as so simple as that?
Doctor: You can keep them as friends, but you cannot expect what you need, maybe you have to find some other friends.
Patient: yeah, of course. I came to that conclusion when I talked with that friend and he literally said during the conversation “I don’t need that stuff, I don’t need that in my life”, he did not say it so that I could get to sleep. He made it apparent that it wasn't needed and that “If you need that is all good, so let us talk about something else”.
Doctor: so you cannot meet them on that level.
Patient: no, I actually can't, I fall short of their level, but I am way there on a different level, but their level is here.
Doctor: their level. So what is the problem, that’s the point, what makes you depressed? Is it a kind of grief, of loss of friends? What is going on in you, what makes you depressed? It is better to look at yourself then looking at them.
Patient: definitely. Apart from restrictions caused by multiple sclerosis, because that is a thing, it feels that it is definitely a driving force to my depression. Apart from that it is about how I am useless socially, with this group of friends in particular I cannot get on a level with them, hanging out never feels comfortable, and when it's uncomfortable I am just thinking why I am not being comfortable, and I think about that until the next time I see them, and then I think a lot of the time, thinking about why it was uncomfortable with them.Follow up after 2 yearsPatient: yes, I am doing very well. I have been able to move on, move in back with my girlfriend. I have had a few jobs since the first consultation and I am presently working for IBM in some IT, maintenance, server thing. I'm doing that the last six months. I don't need a walking stick, I am asymptomatic. I think all in all life has taken a sharp 180° turn. I feel, even when I'm tired at the end of the day: good. It is like night and day compared to the first consultation. Life has been treating me well, better then it has been doing the years before.
Doctor: dear have any symptoms left of the multiple sclerosis?
Patient: there is a slight insensitivity in the fingers of my left-hand, the sensitivity ether is not hundred percent, but that has been since the time of the first diagnosis. Further no symptoms, no double vision. It seemed that everything was wrong at a certain point, but now I am operating perfectly fine, and very well. I have a sincere appreciation of What you're done for me.
Doctor: what score would you give yourself on quality of life?
Patient: even when I'm asymptomatic, I feel that's the last three years have Had an impact on me socially, so I was very withdrawn from social situations for a very long time and I think I'm still recovering from that little bit. So taking that into consideration I want to give myself an 80. If you can't be in the midst of being out with friends I would see 85, 90. I really feel I'm living a life is good, multiple sclerosis why is as good as as I could possibly hope for
Doctor: what score would you have give yourself before on quality of life?
Patient: Less than 40, probably 20. It is so relative, it could have been much worse with me. Initially when I first saw you, my life was ripped upside down. I would have scored myself very low, maybe 20. I was not happy, very unhappy. That's not my life right now. The remedies have done a tremendous job. I'm not taking any medicines that moment.