April 10, 1991

The patient was seen for 35 minutes by himself and 10 minutes with his mother. He continues on nortriptyline, 100 mg at bedtime, and is only using 10 mg of Bethanocol for dry mouth every three to four days. He feels that his overall depression continues to improve steadily. He continues to be free of suicidal ideation. Affect remains flat and even he admits that's a personality style he had always had and is a family characteristic. Engaging him in conversation was initially difficulty, although he began to talk about more about events at school towards the end of the hour and interaction with his family. It became more apparent that he does not feel close to any of his older relatives outside of the family and views his grandparents as somewhat demanding and intrusive. Because I will be out of the area the next month, he was rescheduled for May 21.

The Cheese Man, M.D.