September 11, 1991

The patient was seen for 30 minutes for medication review and follow-up. He has been having more feelings of depression and discouragement recently and more difficulty getting along with his parents. He is taking only community college classes this fall, although he will not graduate from high school until he completes another English course at college. He is also working at the McDonalds in Bend. He feels that many of his current problems are more related to difficulties getting along with his parents, but tends to put most of the blame on their behavior. He states he is feeling the urge to separate from them and would like it if he no longer had to live at home. Because of increased depressive feelings, I recommended he raise his Pamelor back from 75 to 100 mg HS. I would like to see him again in one week for a full hour for psychotherapy.

The Cheese Man, M.D.