Gil, Bipolar I Disorder, Current or Most Recent Episode Hypomanic, Substance Use Assessment A-2

A middle-aged man has rapid, pressured speech and labile shifting affects compatible with bipolar disorder, but calms as he talks. His speech is sometimes tangential, not making sense. He is asked about medications and alcohol intake. He admits to drinking on weekends, but not on weekdays. He reports often getting intoxicated when he drinks because drinking makes everyone happy. He says he usually passes out once each weekend, and also has black outs that he likes because it stimulates him with his art and music. He reports when he drinks he makes comments he regrets. He says he has been arrested twice due to alcohol and that he went to rehabilitation once at the urging of his aunt and the staff members at the center. He reports he was only in the center for one weekend. He reports he often has morning tremors after a weekend of drinking. He denies ever trying to stop drinking. He denies using cannabis but stopped because he felt paranoid. He also does not like that cannabis because it slows his thoughts and he has things to do. He prefers being hypomanic. He reports he will use cannabis to slow him if he has to go to court and needs to be calmer, but does not like the feeling. He denies other drug use such as IV drugs.

Copyright (C) Symptom Media

OFF CAMERA: [00:00:29] So Gil I’d like to ask you just a few medical questions.

GIL: [00:00:32] OK.

OFF CAMERA: [00:00:34] About your health. Yeah. So are you on any kind of medications for anything on aspirin.

GIL: [00:00:40] Yes aspirin every day. I take it every day. Because I think they’re disposable ibuprofen. Yeah I prefer ibuprofen for you.

OFF CAMERA: [00:00:48] Does your Dr. know you’re on the aspirin.

GIL: [00:00:50] Yes. Yeah.

OFF CAMERA: [00:00:51] OK good.

GIL: [00:00:52] So she took it every day.

OFF CAMERA: [00:00:54] What about alcohol. Do you.

GIL: [00:00:57] Yes I think you drink I haven’t.

[00:00:59] How often do you drink alcohol.

GIL: [00:01:01] Not all the time just like on the weekend parties all we can situation we go out we have a brunch with champagne. Now we have Margarita’s will be beers. And we have that before the concert for the show’s summer house.

GIL: [00:01:16] And it’s it’s it.

GIL: [00:01:19] It’s only on the weekends but it’s it’s really the best time.

GIL: [00:01:22] I mean it’s the most magical it’s when you’re supposed to anyway I think now what you’re your mate that’s all I know.

OFF CAMERA: [00:01:26] Is that almost every weekend, every once in a while obviously every weekend.

GIL: [00:01:31] I would do it ever ever ever.

OFF CAMERA: [00:01:32] During the weekdays.

GIL: [00:01:33] No matter.

OFF CAMERA: [00:01:34] What if you’re going to a show during the middle of the week or so.

GIL: [00:01:36] I will smoke ice ice milk.

OFF CAMERA: [00:01:39] But on the weekends it’s like two three days of.

GIL: [00:01:43] Oh yes.

OFF CAMERA: [00:01:43] Drinking.

GIL: [00:01:44] Yeah every day.

OFF CAMERA: [00:01:45] Yeah. And do you ever drink enough that you get intoxicated.

GIL: [00:01:48] No. Yes sometimes.

OFF CAMERA: [00:01:50] Sometimes.

GIL: [00:01:51] Most of the time is drunk.

GIL: [00:01:52] Or drunk most of the time it’s creatively fun because it opens you up you know so I can invite all these people to my shows into my house. So when so when you have them the music the champagne right and the tequila. I noticed when you get them together it’s it’s a happy time. So that’s what you want to always have. I think in life you need to have that with everyone as human beings.

OFF CAMERA: [00:02:15] Now do you ever drink enough that you pass out.

GIL: [00:02:18] Yes I pass out

GIL: [00:02:20] How from does that happen.

GIL: [00:02:21] Not a lot, every week and once.

OFF CAMERA: [00:02:24] Once during every weekend. What about blackouts where you can’t remember what happened. You have those because of the alcohol.

GIL: [00:02:33] You know when you do you kind of get these magical visions and memories and everything so the blackouts are actually cool because you get to see all this like it’s an empty canvas. And then I get to really get all painted all the different colours that I that I’m awake when I can actually put that into music or into art.

OFF CAMERA: [00:02:49] What does alcohol ever cause you to do things you regret like saying things to people or doing things with people and you wished you didn’t do it because.

GIL: [00:02:57] You know unfortunately yes drawn to life always get in a fight or something like somebody who’s always there you know always asking for it really.

OFF CAMERA: [00:03:03] What do you get.

GIL: [00:03:04] The ones that really can prove they’re an antagonist.

OFF CAMERA: [00:03:07] Do you have any legal problems because of the alcohol.

GIL: [00:03:10] I have yeah huh. Oh yeah. Haven’t you.

OFF CAMERA: [00:03:13] And it gets in your life sometimes.

GIL: [00:03:14] I mean you’ve had it happen to you before I’m sure.

OFF CAMERA: [00:03:16] Have you ever been arrested because of.

GIL: [00:03:18] Yeah. Once twice as.

OFF CAMERA: [00:03:21] Any of this ever left him going to rehab for the alcohol.

GIL: [00:03:25] Me.

OFF CAMERA: [00:03:26] Right.

GIL: [00:03:26] Yeah I went through rehab once. How is it that I think that’s with my cousin right. He and I went together because he thought it’d be easier I guess because he had a really big problem.

GIL: [00:03:37] So I just went with his. They said his day stay pretty much.

OFF CAMERA: [00:03:42] Was it his idea or your.

GIL: [00:03:43] Was my aunt’s idea.

OFF CAMERA: [00:03:45] Your aunt’s idea.

GIL: [00:03:46] And I think you.

OFF CAMERA: [00:03:47] Said they thought you should stay. Did you mean they the people at the clinic or the rehab center.

GIL: [00:03:55] People said I should stay. They it.

GIL: [00:03:58] It was good.

OFF CAMERA: [00:03:58] I mean how long.

GIL: [00:03:59] Is it when I’m not even worried about it. It wasn’t anything. I feel great about it. They were nice. Very nice thing. If you give me a bed.

OFF CAMERA: [00:04:05] And how long were you there.

GIL: [00:04:06] That was great because I can really get a lot of sleep I told you.

OFF CAMERA: [00:04:10] Right. And how long were you there.

GIL: [00:04:13] I don’t know. Probably weekend.

OFF CAMERA: [00:04:17] And have you had any medical conditions because of the alcohol.

OFF CAMERA: [00:04:22] No getting tremmers.

GIL: [00:04:25] Oh yes. I get tremors in the morning and the Monday morning. Aha. So that’s what the milk does. Milk calms you down need to be taken out.

OFF CAMERA: [00:04:32] Well you drink any alcohol in the morning to try.

GIL: [00:04:34] Never.

OFF CAMERA: [00:04:35] Calm down. So no. No.

OFF CAMERA: [00:04:37] Have you ever said that only starts at 11:00.

OFF CAMERA: [00:04:39] Have you ever tried to stop drinking altogether like.

GIL: [00:04:42] No.

OFF CAMERA: [00:04:42] For several months or even weeks.

GIL: [00:04:45] Never.

GIL: [00:04:46] Drinking to drink is great.

OFF CAMERA: [00:04:48] So you took it.

GIL: [00:04:49] Drinking Puts me in the good spots.

OFF CAMERA: [00:04:51] So you like the alcohol.

GIL: [00:04:53] Yeah. And you know.

OFF CAMERA: [00:04:55] What about marijuana. Do you smoke smoke marijuana or in

GIL: [00:04:59] Never liked it when I was a teenager I smoked it with my friends. We will get down to the little creek or something and we sit there and they would smoke and be like wow I got to try this case and I’m going to be cool if I did that. But it was me being paranoid and tired and scared. Small small small boy so I would walk down the street.

OFF CAMERA: [00:05:17] That was not a good feeling.

GIL: [00:05:19] No.

GIL: [00:05:20] That you know what I mean, did you smoke pot. Have you done it recently slows you down. No. Again you don’t like the slow. Yeah I get a can I get things that do. It really is tiring. It’s crazy.

GIL: [00:05:31] So it’s not like to let light levels down.

OFF CAMERA: [00:05:34] So you talk about the fast racing thoughts.

GIL: [00:05:37] Yeah it slows as well. Yes it does it does. Yeah. And you don’t want to like that because I have to. I have to work so I feel guilty so I have to. This was me down was like going in the middle of a song and I did it and it’s like flat.

GIL: [00:05:52] So does make this marijuana. When’s the last time you used marijuana.

GIL: [00:05:57] Yeah. Someone gave me one of those new sticks the vaporizer or the tape.

GIL: [00:06:04] I did that and that was bad. It was really bad.

OFF CAMERA: [00:06:07] What was bad about it.

GIL: [00:06:08] It made me sad.

OFF CAMERA: [00:06:09] Sad.

GIL: [00:06:10] And sad and scared so small that it.

OFF CAMERA: [00:06:15] Did it ever make you hallucinate.

OFF CAMERA: [00:06:16] You hear things or see things that are.

GIL: [00:06:18] Picture their.

OFF CAMERA: [00:06:19] Picture.

GIL: [00:06:19] Picture.

GIL: [00:06:20] Yeah like the evil yeah like scary you know aha. Like you know scream the movie or Halloween or something like pictures.

OFF CAMERA: [00:06:30] Gory or.

GIL: [00:06:31] Yes dead dogs and dies.

OFF CAMERA: [00:06:34] So you saw dead dog.

GIL: [00:06:35] Yes I don’t want to say that again. It’s bad murder.

OFF CAMERA: [00:06:39] So you’ve been staying away from that.

GIL: [00:06:43] Yes huh.

OFF CAMERA: [00:06:44] How about in any other form like in foods or oils or.

GIL: [00:06:49] Yeah. One time mistake someone gave me talk to cookie with chocolate chip cookies. You thought that was really delicious and it made me all crazy and then I went into this place complete quiet.

OFF CAMERA: [00:07:05] Just a couple more questions about marijuana.

OFF CAMERA: [00:07:10] You said that slows down your thoughts here. Is it ever in a good way that it kind of slows down your thoughts.

GIL: [00:07:18] Yeah like when you’re around my grandmother died. It’s like you go to a funeral problem early on it really takes all the edge off. And then in court like in a courthouse situation where you’re on trial or something he it just you know calm you can handle the situation. So use it for situations like that. Yeah. Yeah I don’t like to do that. But I do I have to have you I wouldn’t get through it.

OFF CAMERA: [00:07:47] Have you ever gotten in legal trouble because of the marijuana.

GIL: [00:07:52] Legal.

GIL: [00:07:53] Imprison.

OFF CAMERA: [00:07:54] Or arrested.

GIL: [00:07:55] Yes. Oh yeah. Yeah. And it wasn’t my fault again. She was around some of them doing it and I just I just take a taste of it right. And then all of a sudden I’m like I can’t talk. So it’s like I can’t get myself out of this situation is probably a lie. But it makes me feel better.

GIL: [00:08:13] It makes you feel like I can handle it. Right. I mean I mean right.

GIL: [00:08:21] I mean it calms you it slows down some of your heart and your brain and everything’s like.

OFF CAMERA: [00:08:25] A lot of people with bipolar disorder. They say you know slows down their thoughts.

GIL: [00:08:30] Yeah. Oh it does. Yeah. The most. Yes.

OFF CAMERA: [00:08:34] Any other drugs.

GIL: [00:08:35] No.

OFF CAMERA: [00:08:36] Pain meds.

GIL: [00:08:36] No.

OFF CAMERA: [00:08:37] Prescribe.

GIL: [00:08:37] I don’t want taking.

OFF CAMERA: [00:08:39] Opiates heroin and shooting up with needles I.V. drugs.

GIL: [00:08:44] No.

GIL: [00:08:45] Would you do that.

OFF CAMERA: [00:08:46] No.

GIL: [00:08:47] Never.

GIL: [00:08:49] That’s bad. Now that’s bad.

OFF CAMERA: [00:08:51] And It could be dangerous.

GIL: [00:08:53] No, not that bad.

OFF CAMERA: [00:08:55] OK. Well thanks to pretty much just. OK well thanks for talking with us.

GIL: [00:09:00] Well thank you for asking me this.

GIL: [00:09:03] I feel better think they could use a scotch right now.