August 14, 1991

The patient was seen for 30 minutes for medication follow-up. He continues on Nortriptyline, 75 mg at bedtime. He is generally sleeping adequately on this dosage and does not want to change it at this time. He has not had reoccurence of suicidal thoughts. He continues working at McDonalds as a summer job and wants to work there part-time after he starts at the community college this fall. He had limited new material to report this time and was not very talkative, yet at the same time did not indicate significant problems with depression. He continues to live at his parent home and notes that he tends to have “nightmares” where they are shouting at him or criticizing him for problems after he has had occasional confrontations with them. He did not seem overly disturbed by the nightmares and also commented that when the has other kinds of nightmares he finds them entertaining. At this point, he does not appear strongly committed to deal with issues and individual therapies but does appear to be coping relatively well with day to day situations. I would like to see him again in one month for medication follow-up.

The Cheese Man, M.D.