Behavioral Health Episodes by KE Torkelson MS Et.al. (2026)

 

Associated Documents (CIM)

Sponge - What is a behavioral health episode?

A behavioral health episode refers to a period of time when an individual experiences a significant change in their mental or emotional state, often involving symptoms of a mental health or substance use disorder, or a crisis related to these issues. It can include a range of experiences, from a single episode of psychosis to a more extended period of depression or substance abuse.

 

Results up Front

Associated with > Metadata >

Assess_Sleep_Disorder_Self_Test_23092702_Notes V2025

 

Scores for Keith Torkelson MS (Self-scores)

Ending the Episode (2023-2025) – 9 Items - Progress

(*) Coping In-house Metadata >

HUSR_221_Depth_11100901_Coping V2025

 

HSF = High Scores are Favorable | JB = John Baer | RT = Real Time | SW = Share (d) With

What ends a behavioral health episode?

“A behavioral health episode typically ends when targeted treatment goals are met, when there's a failure to meet these goals leading to a referral for direct psychiatric care, or when there's a break in the episode, such as no CoCM (Coordinated Care Model) for 6 consecutive months.”

 

Coordinated Care Model

Care coordination models are structured, patient-centered approaches designed to organize patient care activities across providers to improve efficiency, safety, and health outcomes. These models, such as Patient-Centered Medical Homes (PCMH) and community health worker programs, streamline communication, reduce hospitalizations, and manage chronic conditions.

 

Here's a more detailed explanation:

Goal Achievement

“A primary factor in ending a behavioral health episode is when the individual successfully achieves the treatment goals outlined in their care plan.”

Failure to Meet Goals

“If, despite efforts, the individual does not make sufficient progress towards their goals, the episode may end, and a referral for more specialized or intensive care may be initiated.”

Break in Episode

“A break in the episode can occur if there's a cessation of care or services for a prolonged period, such as 6 consecutive months without CoCM.”

Other Considerations

Medication Management

“The need for medication may also influence the duration of an episode, with some individuals requiring long-term medication management, while others may be able to gradually reduce or discontinue medication as their symptoms improve.”

Psychological Therapies

“Therapies like cognitive behavioral therapy (CBT) and family interventions can play a crucial role in managing symptoms and improving overall well-being, potentially leading to a shorter episode.”

Social Support

“Access to social support networks, including family, friends, and support groups, can significantly impact recovery and the length of an episode.”

Crisis Intervention

“In cases of acute mental health crises, inpatient or residential treatment may be necessary, followed by a transition to less intensive levels of care like partial hospitalization programs.”

Working your own Program

Working your own program generally refers to taking personal responsibility for achieving specific life goals, such as recovery from addiction or building a business. It involves self-direction, creating a customized plan, implementing self-management techniques, and holding oneself accountable for outcomes.

 

 

Psychosis and Mental Illness - Better Health Channel (Key Word Psychosis)

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/psychosis.

 

How long does a mental health episode last?

Some people only experience a few episodes of psychosis, or a brief episode that lasts for a few days or weeks. Others will experience symptoms more frequently, in association with a longer-term illness such as schizophrenia. The first episode of psychosis usually occurs in a person's late teens or early 20s.

 

Symptoms of Psychosis include

Approaches

Atypical Behaviors

Atypical behaviors are actions that deviate from what is considered typical or expected for a child's age and developmental stage. These behaviors can manifest in various ways, including difficulties with social interaction, communication, or emotional regulation. While some atypical behaviors might be isolated incidents or related to individual differences in development, persistent or severe atypical behaviors can indicate developmental delays or challenges that may warrant further evaluation and support.

 

Atypical Feelings

Atypical feelings, as they relate to atypical depression, refer to a specific subtype of major depressive disorder characterized by mood reactivity to positive events and other unique symptoms. While someone with atypical depression experiences the core symptoms of depression (low mood, loss of interest, etc.), they also exhibit the ability to temporarily feel better when something good happens. This contrasts with other forms of depression where mood doesn't lift in response to positive events.

 

Mood Reactivity to Positive Events

Mood reactivity to positive events refers to a temporary improvement in mood or a "brightening" effect when experiencing positive events, a hallmark symptom of atypical depression. While often associated with depressive disorders, it can occur in others, involving stronger emotional shifts, such as reduced negative affect, compared to non-depressed individuals.

 

Phantosmia

Phantosmia is a condition where you perceive smells that aren't actually present in your environment, also known as olfactory hallucinations. These phantom smells can be unpleasant, like burning rubber, garbage, or rotting food, or they can be more neutral or even pleasant smells. Phantosmia can be a temporary issue or a persistent one, and it can affect one or both nostrils, according to the Cleveland Clinic.

 

Volunteering

Volunteering is the act of donating one's time and effort to a cause, often for community service or to support a particular organization. It can involve a wide range of activities, from helping with food distributions and mentoring youth to supporting disaster relief efforts and providing administrative assistance. Volunteering can be a great way to connect with others, develop new skills, and contribute to the well-being of your community.

 

Global Assessment of Functioning (GAF)

The Global Assessment of Functioning (GAF) scale, formerly used in the DSM-IV, rates1-100 to measure mental health, with higher scores indicating better functioning. For individuals working or attending school, scores typically fall between 51 and 80: 71-80 (slight impairment), 61-70 (mild difficulty), or 51-60 (moderate difficulty).

 

Seventy-eight

>On 20251015 Dr. RB Bera scored us with a 78.  Without going to school full time or working full time successfully we will not be able to improve our GAF score.  We are satisfied with a score of 78.  Our lowest reported GAF was 30.

 

Function without medication

Living well without medication is possible for some conditions, and often involves a combination of lifestyle adjustments and therapeutic approaches. Focusing on a healthy diet, regular exercise, stress reduction techniques, and potentially exploring therapies like psychotherapy or neurofeedback can be effective strategies.

 

Importance of Sleep to Behavioral Health

Sleep is a fundamental pillar of behavioral health, acting as a crucial restorative process for emotional regulation, cognitive function, and mental resilience. It repairs neural pathways, consolidates memories, and processes emotions, with poor sleep directly linked to increased irritability, stress, anxiety, and risk for depression.

 

Pass Mental Status Exam (MSE)

To "pass" a mental status exam (MSE), focus on being honest, providing clear and accurate information about your symptoms and how they impact your daily life, and cooperating with the examiner. There isn't a specific score to "pass," but rather the goal is to present a realistic and comprehensive picture of your mental health to the examiner.

 

Complete Treatment Plan

A comprehensive treatment plan is a detailed, personalized roadmap for a patient's care, outlining specific goals, interventions, and expected outcomes. It serves as a guide for healthcare providers, patients, and sometimes their families, ensuring a structured approach to addressing identified needs and achieving desired results.

 

Completing Treatment Plan

Completing a treatment plan involves outlining specific, measurable, achievable, relevant, and time-bound (SMART) goals, along with corresponding objectives and interventions, to guide a client's therapeutic journey. The plan should be collaboratively developed, regularly reviewed, and adapted to the client's progress and changing needs.

 

Maintain Treatment Plan

Maintaining a treatment plan involves regularly reviewing, updating, and adhering to a personalized plan developed between a healthcare provider and a client. This includes setting goals, identifying interventions, and tracking progress to ensure the plan remains relevant and effective. It's a collaborative process that requires ongoing communication and adjustments based on the client's needs and progress.

 

How is it we would call 911?

 

• Avoid Danger
• Avoid Suffering
• Contain Risks associated with lack of sleep
• Need a new bed
• Need a new facility
• Need a new roommate
• Open up an opportunity

 

Hospitalization

An inpatient may undergo the same treatment as an outpatient, but the outpatient is at the hospital for treatment and then leaves; the inpatient is hospitalized. Does hospitalized mean overnight? A hospitalized person has been admitted to a hospital as an inpatient—usually (but not always) with an overnight stay.

 

Psych Ward

A psych ward, also known as a psychiatric ward or unit, is a specialized part of a hospital providing short-term, inpatient care for individuals experiencing acute mental health crises. It offers a secure environment with 24/7 care from trained professionals like psychiatrists, nurses, and social workers. Psych wards are designed to stabilize patients and begin the process of developing a longer-term treatment plan.

 

Acute Behavioral Health Crisis

An acute behavioral health crisis is a sudden, severe episode of emotional, mental, or substance-use distress requiring immediate intervention to prevent harm to self or others. Key signs include suicide threats, extreme agitation, paranoia, or psychosis. Immediate help is available via 988 in the US,, along with mobile crisis teams and emergency stabilization units.

 

Crisis Mechanisms

Episodes – Keith “Buster” Torkelson, MS

An episode includes at least one hospitalization

Is seven a lot of behavioral health episodes?

Whether seven behavioral health episodes are considered "a lot" depends heavily on the context, such as the timeframe, the severity of the episodes, and whether they involve acute crises (like hospitalizations) or ongoing outpatient treatment. Based on the provided search results, 7 is not a standard, recognized benchmark for "high utilization" in literature, but it suggests a significant, ongoing need for care

 

Promotion - Centralized Assessment Team (CAT) in Orange County

The Mobile Crisis Assessment Team (CAT)

Located in: Orange County Health Care Agency

Address: 2035 E Ball Rd #200, Anaheim, CA 92806

Phone: (714) 517-6353

Call OC Links 24/7 at (855) 625-4657

This multi-disciplinary program provides prompt response in the county when an individual is experiencing a behavioral health crisis. Clinicians respond to calls from anyone in the community 24 hours a day, 7 days a week year-round and dispatch to locations throughout Orange County. Clinicians receive specialized training and are designed to conduct evaluations and risk assessment that are geared to the individual's age and developmental level. The evaluations include interviews with the individual, as well as parents, guardians, family members, law enforcement, emergency department staff and/or school personnel, if available. Clinicians link individuals to an appropriate level of care to ensure their safety, which may involve initiation a hospitalization. CAT clinicians also follow-up with individuals and/or their parents/guardians to provide information, referrals and linkage to ongoing behavioral health services that may help reduce the need for future crisis interventions. (Source = MHSA...p,107)  The CAT also includes the Psychiatric Emergency Response Teams (PERTs), which consist of CAT clinicians who are stationed or ride along with assigned law enforcement officers to address behavioral health-related calls in their assigned city. PERT provides all the same services as CAT and also initiates involuntary hospitalizations as necessary. (Source =  MHSA...p.106)

 

Avoiding a Behavioral Health Crisis

Avoiding a behavioral health crisis involves proactive self-care, building a strong support system, recognizing early warning signs, and establishing a crisis plan (e.g., Wellness Recovery Action Plan) that includes therapist contacts, triggers, and coping strategies. Key preventative steps include maintaining a routine, engaging in enjoyable activities, and utilizing resources like 988, the 988 Suicide & Crisis Lifeline, for immediate support.

 

Crisis Intervention Management

Crisis intervention management is immediate, short-term psychological care designed to stabilize individuals in acute distress, restore equilibrium, and minimize long-term trauma. It utilizes techniques like active listening, safety planning, and de-escalation to address crises involving trauma, mental health, or violence. Effective management involves trained professionals and structured, action-oriented strategies.

 

Ending a Behavioral Health Episode involving hospitalization

Ending a behavioral health episode involving hospitalization involves a structured, multi-step process focused on stabilization, safe discharge planning, and continuity of care to prevent relapse or rehospitalization. The process shifts from acute, 24-hour care to outpatient treatment, typically involving a "step-down" approach to lower-intensity care.

Treatment in the hospital versus treatment in the community

Hospital treatment provides intensive, 24/7 care for acute crises and severe, complex conditions requiring immediate intervention and specialized technology. Conversely, community-based treatment offers a patient-preferred, cost-effective alternative that improves quality of life, aids long-term recovery, and fosters independence, though it requires robust support structures to be effective.

 

2026 - Costs without assistance (Magnitude per year)

Approximations for Keith “Buster” Torkelson, MS

Assisted Living Waiver

The Assisted Living Waiver (ALW) program is a Medicaid-funded initiative (e.g., in California, Ohio, and Mississippi) designed to help low-income seniors and individuals with disabilities, who require a nursing facility level of care, transition into or remain in a residential, assisted living setting. The program covers care services but generally requires residents to pay for their own room and board.

 

How much is a bed at Harvest Retirement in Buena Park?

Costs for a bed at Harvest Retirement in Buena Park vary by care type and room, typically ranging from $2,500 to over $7,900 per month. Assisted living options generally start around $3,413–$6,077 for shared/studio units, while memory care can start at $2,500 for shared rooms up to $4,400 for private, with prices subject to change.

 

If I call 911 again I want to…See End of Life Related – Work Done

https://healthman2059.blogspot.com/2025/08/eolcca-centered-medical-aid-in-dying-by.html

 

https://the-torkel-saga-2059.blogspot.com/2025/08/eolcca-centered-medical-aid-in-dying-by.html

Qualitative Study of QOL & Housing & Living Arrangements by Keith Torkelson, MS, BS V HealthMan

 

Index of Key Concepts (Elimination)

 

• Living Arrangements Operators (Owners)
• Living Arrangements Housing Bed Sales
• Physical QOL Factors
• QOL Associated Products
• Quality of Life and Housing – Product Exploration Index
• Quality of Life Indicators - Measuring Quality Of Life
• Query “Quality of Life and Housing” Hits
• Housing Solutions Bundle > Ask for Help > Find > Get > Assess > Keep
• Placement
• End-of-life Concerns and Activities

 

Housing Solutions Bundle - Algorithm

Associated Studies > Metadata >

Quality of Life (QOL) is the function, and others are the variables

 

QOL…

 

• Bed Quality Assessment
• Definitions Content_23082610_Notes
• Housing and Intimacy
• Housing Eclectic_23072904_Notes
• Housing LA_Sex_23060902_Notes
• Housing Public_Health_Efforts_and_Entities_23072905_Notes
• LA Rate_Your_Housing_18102601_Resources_Specialists
• Loss Management_23072205_Notes
• Noise 23061002_Notes
• Populations_23072206_Notes
• QOL Housing_Eclectic_LxE_23072904_Notes
• Roommate Matching
• Self-sufficiency Dependency_23062501_Notes
• SEQOL COTS_23072907_Notes
• Spirit
• Taking Action Housing_Items_23072207_Notes
• Wellbeing

Functions

Housing (QOL)

Housing as a function for Quality of Life

Housing is a fundamental function for Quality of Life (QOL) because it meets basic needs for shelter and security, but its impact extends to physical and mental health, social well-being, and economic stability. Factors like housing satisfaction, stability, affordability, and quality of the physical structure and surrounding environment all influence QOL. Conversely, poor housing conditions and high costs can negatively affect health outcomes and overall life satisfaction.

Housing (QOL Variable)

Housing as a function of Variable QOL

Housing is a significant variable in Quality of Life (QOL), where housing quality and stability positively impact QOL. As a function of QOL, stable housing, particularly permanent supportive housing models like Housing First, is associated with higher QOL, while factors like poor housing conditions (e.g., lead, mold, [Bedbugs]), overcrowding, and homelessness are linked to negative health and well-being outcomes. The relationship is also influenced by other factors, such as social integration, meeting needs, and individual health.

QOL as a function of Housing

Housing is a key determinant of quality of life (QOL), as its quality and environment influence physical health, mental well-being, and social functioning. Factors like physical attributes (heat, noise, [Light]), biological hazards (mold), chemical exposures, and social environment (crime, social exclusion) are all linked to housing conditions and directly impact an individual's perceived well-being.

Function

A "function" can refer to the purpose or role of a person, thing, or institution, the mathematical relationship where each input has a single output, or a social gathering. In common language, it describes what something is for (e.g., a heart's function is to pump blood). In math and science, a function is a specific rule that takes an input (like (x)) and produces a unique output (like (f(x)).

Housing and QOL – Housing (QOL)

Housing is a fundamental component of Quality of Life (QOL), impacting both physical and mental well-being through its stability, quality, and the surrounding environment. High-quality, stable, and affordable housing positively influences overall life satisfaction, while poor housing conditions are linked to health issues, social exclusion, and a lower quality of life. Key aspects include the physical condition of the dwelling, factors like safety and noise, and the availability of neighborhood services and green spaces.

What does quality of housing mean?

Housing quality refers to the physical conditions of a person's home as well as the quality of the social and physical environment in which the home is located. Poor-quality housing is associated with various negative health outcomes.

Aside - Character Counts - What is the meaning of Character Counts?

Character Counts! is a character development framework based on shared beliefs and consensus values concerning qualities and traits associated with good character. These values transcend cultural, socio-economic, and religious differences. Character education is all about a way of life for children and adults.

Query “Quality Of Life and Housing” - Hits

Quality of Life Housing

Metadata >

LA_Housing_Bed_Sales_and_Operators_23082609_Notes

Public Housing

Public housing, also known as social housing, refers to housing units owned and managed by a government or non-profit organization, designed to provide affordable rental options for low-income individuals and families. It differs from Section 8 housing, where the property is privately owned, but the tenant receives rental assistance.

Housing Quality and Public Health

Access to affordable and quality housing is a crucial social determinant of health and well-being. Variations in housing access and quality contribute significantly to disparities in quality of life across different populations. Addressing these disparities through policies and initiatives that promote affordable, accessible, and adequate housing is essential for improving public health and promoting equity.

Affordable Housing

The U.S. Department of Housing and Urban Development defines “affordable housing” as housing on which the occupant is paying no more than 30 percent of gross income for housing costs, including utilities. Jan 8, 2024

Factors of Housing Satisfaction

Housing satisfaction refers to the level of contentment individuals feel about their living environment, encompassing both the dwelling itself and its surrounding neighborhood. It's a key aspect of overall life satisfaction and is influenced by various factors, including physical characteristics of the home, social aspects of the neighborhood, and the individual's personal needs and preferences.

Housing and Health

Housing is a fundamental social determinant of health, significantly impacting physical and mental well-being. Housing stability, quality, and affordability all play a crucial role in health outcomes, while factors like neighborhood safety and access to resources also contribute. Poor housing conditions can lead to a range of health issues, including chronic diseases, injuries, and mental health problems, while stable and healthy housing can promote well-being and prevent long-term health issues.

Dental

To budget for affordable dental care, prioritize preventive care, explore low-cost or free clinics, and consider dental insurance plans or discount dental plans. You can also inquire about payment plans, use FSA/HSA funds, and look for community resources like dental schools or non-profit organizations.

Transportation

Transportation is the movement of people and goods from one place to another using various means and infrastructure. This movement can be accomplished through different modes like land (cars, trains), water (ships), and air (airplanes), and is supported by a complex system of infrastructure such as roads, bridges, and ports.

Retirement

Retirement signifies the end of one's active working life, often occurring in later years or due to health issues. It involves withdrawing from one's occupation or active working life, potentially with reduced work hours or workload (semi-retirement). Retirement planning involves considering various factors like Social Security benefits, savings goals, and health considerations.

Assisted Living (AL)

Assisted living provides housing and support services for seniors who need help with daily tasks but do not require the intensive care of a nursing home. It offers a balance of independence and assistance, allowing residents to maintain a level of autonomy while receiving support with activities like bathing, dressing, and medication management.

AL Waiver

The Assisted Living Waiver (ALW) program in California is a Medicaid HCBS waiver that allows eligible Medi-Cal recipients needing nursing facility-level care to receive services in a less restrictive, community-based setting like an assisted living facility or subsidized housing. This program aims to provide an alternative to nursing home care, offering a more comfortable and familiar environment for individuals while also potentially reducing costs for the state.
Quality Of Life and Housing – Notes

Share with (Metadata) 05_DA_QOL_Housing_18101401_Develop
Share with Housing Advisory Board (HAB)
Epidemiology – Quality Of Life (QOL) About Housing
People and Things

Associated Study > Metadata >

13_Tech_MyCorder_24022002_Notes V2025

Reasons to go to the Psych Ward

People go to the psych ward (inpatient mental health facility) for severe crises like suicidal/homicidal thoughts, severe psychosis ((*)hallucinations/delusions), extreme mood swings (mania/severe depression), inability to care for self, or dangerous substance withdrawal, requiring 24/7 stabilization, medication management, and safety when outpatient care isn't enough to prevent harm. It's for acute stabilization when someone is a danger to themselves or others, or severely impaired.

(*)

Presenting Problems

• Sleep Disorder
• Anxiety

Epidemiology – Persons and Populations
Quality Of Life (QOL) About Housing
Things

Aside - Solutions for Transitional Aged Youth
Sample Program Keeping Good Statistics
From Formal Presentation - Casa Youth Shelter
2011 Fall Quarter – Cypress College

 

Mission Statement

“The purpose of Casa Youth Shelter is to provide temporary shelter for runaways and youth in crisis, enabling them to come through the crisis with increased personal strength and a sense of renewal while in a supportive environment with family reunification as the primary goal.”

https://casayouthshelter.org/impact/

Aside (2026)

Buster in Spanish - Have a nice day

que tenga un lindo día

Myra - Responded: “I love you.”

 

Associated Study > Metadata >
Share with 05_DA_QOL_Housing_18101401_Develop
Table – Housing and QOL
QOL Centered About Housing - Indicated by (Brief List)
Share with Housing Advisory Board (HAB)

Peace in Death, Disease, Disaster over Time (P4D)

The question is a bit ambiguous, but it seems to be asking about finding peace in the face of death, disease, and disaster, potentially over time. One approach to finding such peace is through a faith-based perspective, as explored in the book "Death, Disease, Disaster, & Despicable Evil: Finding Peace in the Face of Tragedy" by Dr. Michael Messina. The book combines psychological principles with biblical wisdom to offer guidance on navigating life's toughest challenges. It suggests that while tragedy is inevitable, overwhelming emotions don't have to be, and that finding peace can be achieved by reshaping thoughts and responses through a Christ-centered perspective, according to ThriftBooks and Cokesbury.

Summary

Examining the interplay of death, disease, and disaster over time reveals a complex and evolving relationship with societal peace and conflict.  In summary, death, disease, and disaster can trigger social disruptions and exacerbate existing conflicts. However, they also present opportunities for cooperation, empathy, and peacebuilding if societies prioritize inclusive recovery efforts, strengthen institutions, and address underlying vulnerabilities.

Continuum of Care

A Continuum of Care (CoC) is a planning body that coordinates housing and service funding to address homelessness within a specific geographic area. It's a community-wide effort involving various stakeholders like nonprofits, government agencies, and advocates to provide a range of services to help individuals and families experiencing homelessness transition into stable housing.

 

Aside – Board of Supervisors

https://d1.ocgov.com/

Wiki – Content – WikiContent - QOL

https://en.wikipedia.org/wiki/Quality_of_life

QOL Overview

Quality of life (QoL) is a concept that aims to capture the well-being of a population or individual regarding both positive and negative elements within the entirety of their existence at a specific point in time.

Quantitative measurement

Quantitative measurement refers to the process of determining the quantity or amount of something using numerical values. It involves using numbers to represent and analyze data, allowing for objective comparison and statistical analysis. Essentially, it's about measuring "how much" or "how many".

Human Development Index (HDI)

The Human Development Index (HDI) is a metric developed by the United Nations Development Programme (UNDP) to measure a country's level of development across three key dimensions: health (life expectancy), education (average and expected years of schooling), and living standards (GNI per capita). It uses a score between 0 and 1, with higher scores indicating greater development.

World Happiness Report

The World Happiness Report is the world's foremost publication on global well-being and how to improve it. We combine well-being data from over 140 countries with high-quality analysis by world-leading researchers from a wide range of academic disciplines.

Other measures Such as Satisfaction

Measuring satisfaction, whether it's customer satisfaction or employee satisfaction, is a crucial aspect of business and organizational success. It provides valuable insights into how people perceive your product, service, brand, or workplace, helping you understand what's working well and what needs improvement.

Aside - Context of Assisted Living (AL)

Customer Churn Rate

Customer churn rate is a key performance indicator (KPI) that measures the percentage of customers who discontinue their service or relationship with a business over a specific period. It's a crucial metric for understanding customer retention and identifying potential issues that may be impacting customer satisfaction and loyalty.

Customer Retention Rate

Customer retention rate (CRR) measures how well a business keeps its existing customers over a specific period. It's a crucial metric for assessing customer satisfaction, loyalty, and the overall health of a business. A higher CRR generally indicates greater customer loyalty and potentially lower customer acquisition costs.

Online Rating/Reviews

Online ratings and reviews are crucial in today's digital landscape, influencing consumer decisions, business reputation, and search engine optimization (SEO). They encompass feedback and ratings left by customers on various platforms like Google, Yelp, Trustpilot, social media, and more. Businesses across industries leverage these platforms to gather insights, build credibility, and ultimately drive growth.

Social Media Sentiment

Social media sentiment refers to the overall feeling or attitude expressed by people about a specific topic, brand, product, or service on social media platforms. It's a key metric used to gauge public opinion and understand how people perceive a particular entity online. Sentiment analysis, often done through tools, helps categorize this information as positive, negative, or neutral, and can reveal deeper emotional tones

Livability

Livability refers to the quality of a place, encompassing factors like safety, affordable housing, and accessible transportation that support the long-term well-being of residents. It includes community features and services such as parks, education, healthcare, and opportunities for social and civic engagement, ensuring residents can thrive regardless of age, background, or ability. Ultimately, a livable community enhances residents' personal independence and allows them to age in place.

QOL and Crimes

Quality of Life (QOL) and crime are interconnected, with both crime and perceptions of disorder negatively impacting residents' QOL. Specifically, increased violent crime can decrease QOL, while addressing "quality of life" (QOL) crimes like public disorder can improve it.

Popsicle Index

The Popsicle Index is a simple way to assess the safety and walkability of a neighborhood, particularly for children. It's based on the question: Can an 8-year-old child safely walk to a store, buy a popsicle, and return home before it melts? The index doesn't rank neighborhoods numerically, but rather serves as a qualitative measure of safety and accessibility.

QOL and Healthcare - AI Overview

Quality of Life (QOL) in healthcare refers to an individual's overall sense of well-being and satisfaction with their life, encompassing physical, psychological, social, and functional aspects. It's a crucial concept in healthcare because it acknowledges that health outcomes are not solely defined by disease or treatment but also by how these impact a person's overall life experience.

QOL Defined (Wikipedia)

“Quality of life (QOL) is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns".”

Standard Indicators of QOL

“Standard indicators of the quality of life include wealth, employment, the environment, physical and mental health, education, recreation and leisure time, social belonging, religious beliefs, safety, security, and freedom.  QOL has a wide range of contexts, including the fields of international development, healthcare, politics, and employment. Health-related QOL (HRQOL) is an evaluation of QOL and its relationship with health.”

What is the true meaning of suffering?

Suffering - Wikipedia

Suffering, or pain in a broad sense, may be an experience of unpleasantness or aversion, possibly associated with the perception of harm or threat of harm in an individual. Suffering is the basic element that makes up the negative valence of affective phenomena. The opposite of suffering is pleasure or happiness.

In the next ten years, what will California be like?

In the next decade, California will likely experience an increase in climate change impacts like extreme heat, severe drought, and intense flooding, alongside ongoing economic shifts driven by its transition to a green economy and technological advancements. The state may face budget deficits, and the housing crisis is expected to continue, potentially widening the gap between income levels. To address these issues, the state is focusing on climate adaptation strategies and workforce development to prepare for changes in technology and the job market.

Options

How is it Euthanasia?

Euthanasia is the act of a third party, typically a healthcare provider, intentionally ending a person's life to relieve suffering, often by administering a lethal injection. It differs from physician-assisted suicide, where the patient self-administers a lethal drug prescribed by a physician. Euthanasia can be voluntary (with patient consent), non-voluntary (when the patient is unable to consent), or involuntary (against the patient's will).

Practical - How is it Medical Aid in Dying (MAiD)?

Your doctor writes the prescription for the (medical) aid-in-dying drug, and you sign a consent form for the prescription to be sent to the pharmacy. You (or a caregiver or loved one) retrieve the drug from the pharmacy. You ingest the aid-in-dying drug according to the instructions.

 

FYI - California End of Life Option Act (EOLOA)

UCLA Health

https://www.uclahealth.org/patient-resources/support-information/patient-education/california-end-life-option-act-eoloa

Introduction to the California End of Life Option Act (EOLOA)

The California End of Life Option Act (EOLOA) allows a terminally ill adult with a life expectancy of six months or less to end their life with an aid-in-dying drug. The terminally ill person must be a California resident and must request the drug from their physician. Participating in this end-of-life option is voluntary for both patients and physicians.  People who choose to end their lives this way are not considered to have died by suicide if they carefully follow the steps of the law. Physicians who prescribe the aid-in-dying drug are not subject to legal liability or professional sanction if they follow all the steps outlined in the law.

Promotions

Death with Dignity

https://deathwithdignity.org/states/

Death with Dignity National Center is a 501 nonpartisan nonprofit organization, headquartered in Portland, Oregon, that has led the legal defense of and education about Death with Dignity laws throughout the United States for more than 25 years.

 

End-of-Life Choices California

https://endoflifechoicesca.org/

Transparency
Group Home – Featuring – Gloria’s Guest Home AKA Shanks Truck Stop
Dying Old Men (DOM) and those that Died Too Young (DTY)

 

Advocate for Self-care and Treatment for Sleep Challenges– By Keith Torkelson MS, BS

 

Ability to Communicate

The ability to communicate is the skill of effectively sharing and understanding information, involving clear speaking, writing, and nonverbal cues (body language, tone) and essential active listening, empathy, and adapting to different situations to convey messages and build connections, crucial for personal and professional success. It's a two-way street of both sending clear signals and accurately interpreting others' messages, focusing on clarity, conciseness, and understanding emotions and intent.

 

##	Factor (A-Z)	2025 0521 W-RT SW-JB	2025 0708 TU-RT SW-JB
01	No Alcohol Abuse / Use	1.00	1.00
02	Ambien Benefits (*)	1.00	1.00
03	Little Anxiety	0.50	0.75
04	Ativan Security	0.75	0.75
05	Clozapine Efficacy	1.00	1.00
06	Little Confusion	0.75	0.75
07	Little Dependency	1.00	0.25
08	Little Depression	0.75	1.00
09	Good Concentration	0.60	0.75
10	Appropriate Drowsiness	1.00	1.00
11	No Genetic Mutation related to GABA chemistry (Suspected)	0.50	0.50
12	Managed Insomnia	1.00	1.00
13	Not Irritable	0.75	1.00
14	Few Problems	0.75	0.75
15	Minor Mood Swings	0.75	0.75
16	No Muscle Spasms	0.90	1.00
17	No Panic Attacks	0.90	0.90
18	Short Periods of Stress	1.00	1.00
19	Appropriate Sleepers (**)	1.00	1.00
20	Temporary Stress	1.00	1.00
21	No Tolerance	0.90	0.90
22	No Tremors	0.75	0.75
	CALC	=18.55/22	=18.80/22
	Sleep Associated Strengths Score 22 Items (HSF) =	84.3%	85.5%

(*) – Doctor re-evaluates each appointment

(**) – Alternatives to Ambien

Advocate

>Buster’s niece is his overall advocate and power of attorney.

Last Reviewed: 20260125-SU

FAQ - What is wrong with my brain chemistry?

 

Typical Neurotransmitter Levels in Blood

Typical neurotransmitter levels in blood vary widely, and these levels are not typically used as a primary diagnostic tool for mental health conditions. While neurotransmitters are crucial for brain function, measuring their levels in blood doesn't always reflect their activity in the brain, where they primarily act. Blood levels can be influenced by various factors, including medications, diet, and even physical activity.

 

How is it a Sleep Disorder?

A sleep disorder is a condition that disrupts normal sleep patterns, affecting the quality, timing, and amount of sleep, which leads to daytime distress and impaired functioning. It is identified by chronic issues like taking >30 minutes to fall asleep, frequent waking, loud snoring/gasping, or excessive daytime sleepiness.

 

Practical - Things to Look Up

• Short Term Fixes
• Ambien
• Cognitive Behavioral Therapy
• Diphenhydramine (Benadryl)
• Lemborexant (Dayvigo)
• Lorazepam
• Melatonin
• Restoril
• Trazadone

 

Long Term Fixes

• Adenosine
• Chamomile Tea
• Clozapine
• GABA
• Limit Caffeine
• Limit consumption of alcohol

 

Solution

 

Goals

Sleep all night

Peace and pleasure during the day

Contentment

 

FYI - Diphenhydramine

Diphenhydramine (commonly Benadryl) is a first-generation antihistamine used to treat allergy symptoms (sneezing, itching, hives), the common cold, insomnia, and motion sickness. It works by blocking H1 receptors (reducing histamine) and acting as an anticholinergic. Common side effects include drowsiness, dizziness, and dry mouth. Available in oral, topical, and injectable forms, it should be used cautiously due to potential for sedation and, in overdose, serious heart issues.

 

Alternatives to Ambien

Alternatives to Ambien (zolpidem) for insomnia include prescription drugs like eszopiclone (Lunesta), trazodone, and dual orexin receptor antagonists (Belsomra, Dayvigo). Over-the-counter (OTC) options include melatonin, diphenhydramine (Benadryl), and doxylamine (Unisom). Non-pharmacological approaches like Cognitive Behavioral Therapy for Insomnia (CBT-i) are highly effective alternatives.

 

Housing Position

>Current living situation at Harvest is good enough.  If medication, peace or sleeping goes wrong these would be conditions for relocation.  Our current treatment plan is working yet the doctor indications he wants to stop our Ambien.

 

Team Work

Consumers are becoming more knowledgeable about medications, but professional expertise remains valuable. A combination of consumer research, clear communication from healthcare professionals, and ongoing education efforts is needed to empower individuals to make informed choices about their medications.

 

Medication Position – Shared Decision Making

^>The doctor knows more about our case and what we need.  However, it's equally important to remember that shared decision-making is a crucial aspect of modern healthcare. Based on lived experience and a college education we know our case and needs better than anyone.  Individuals, leveraging their lived experience and educational background, often possess unique insights into their specific circumstances and needs.

 

Sleep

Null Hypothesis - We do not lack the endogenous chemistry to sleep.

Hypothesis – We lack the endogenous chemistry to sleep.

 

FYI - Clinical Chemistry of Sleep - Brain Basics: Understanding Sleep

National Institute of Neurological Disorders and Stroke (.gov)

https://www.ninds.nih.gov/health-information/public-education/brain-basics/brain-basics-understanding-sleep

Feb 25, 2025

Two internal biological mechanisms—circadian rhythm and homeostasis—work together to regulate when you are awake and when you are asleep.

 

Problems with GABA – Risk Factors

^>Due to intense sleep deprivation and interruption Buster appears to lack the natural chemistry for sleep.  Most likely gamma-aminobutyric acid (GABA) is involved.  Ambien is a short term solution yet the doctor is considering taking Buster off Ambien.  Ambien has proven itself over the course of 1-2 years and is something that is effective and well tolerated.  “Long-term reliance on chemical sleep aids, whether prescription or over-the-counter, is generally not recommended due to potential side effects and risks. While some chemicals like melatonin, GABA, and adenosine play a natural role in sleep regulation, excessive or prolonged use of synthetic versions can interfere with the body's natural sleep-wake cycle and lead to complications.”  Without medication Buster has an abnormal sleep-wake cycle.  Before taking him off his “sleeper” we need to come up with something to replace it.  For Buster Ambien is augmented with Lorazepam and CloZAPine.  Without these three medications Buster doesn’t sleep.  Without sufficient sleep his risk factors increase.  As a coping measure for increased risk factors he has a history of calling 911 and ending up in the hospital.  Presently, if Buster were faced with prolonged sleep deprivation (more than 72 hours) he would prefer Medical Assistance in Dying (MAiD).

 

Cost-Benefit

^>Costs are what you give up or spend, while benefits are what you gain or receive from a decision or action. Cost-benefit analysis is a method of evaluating these, often using monetary units, to determine if the benefits outweigh the costs.  In a nutshell, the cost of giving up one of Buster’s sleep associated medication exceeds the benefits.

 

Example Restoril Substitute

Restoril (Temazepam) is a medication used to treat insomnia, helping individuals fall asleep and stay asleep. It's a benzodiazepine that works by slowing down brain activity, but it comes with potential risks like dependence, misuse, and side effects. The cost of Restoril can vary depending on factors like insurance, pharmacy, and dosage.

 

Benefits of Restoril

The key benefits of Restoril for treating short-term insomnia include…

Improved sleep onset

It can help individuals fall asleep faster.

Reduced nighttime awakenings

It can help individuals stay asleep longer by reducing the number of times they wake up during the night.

Enhanced sleep quality

By promoting longer and more continuous sleep, Restoril contributes to a more restorative sleep experience.

Minimal disruption to sleep structure

Unlike older hypnotics, Restoril doesn't significantly disrupt the natural stages of sleep like REM sleep, which is important for brain recovery.

 

Will a Sleep Disorder get Better with Age?

No, sleep disorders generally do not get better with age and may, in fact, become more common. While the need for sleep remains relatively stable throughout adulthood, the ability to achieve restful sleep can decline with age. Many older adults experience difficulty falling and staying asleep, leading to increased nighttime awakenings and reduced deep sleep.

 

Settings

“Hospitalization typically incurs higher costs than the use of benzodiazepines alone, but offers the benefit of a more controlled environment and access to medical professionals for monitoring and treatment. Benzodiazepines can be cost-effective for certain conditions like anxiety or insomnia, but can also lead to adverse events, including falls and accidents.”

 

Are BZDs part of palliative care?

Yes, benzodiazepines (BZDs) are a common and important component of palliative care, frequently used to manage symptoms like severe anxiety, breathlessness, agitation, and terminal restlessness, particularly near the end of life. They are often included in palliative "comfort kits" and used for terminal sedation.

 

Key points regarding BZDs in palliative care:

Commonly Used Agents

Midazolam (often for subcutaneous/IV) and lorazepam are the most frequently used benzodiazepines in palliative settings.

Indications

They are primarily used for anxiety, panic, terminal agitation, insomnia, and dyspnea (breathlessness).

Palliative Sedation

BZDs, especially midazolam, are considered frontline medications for palliative sedation when symptoms are refractory.

Risks & Considerations

While beneficial for comfort, they can cause sedation, cognitive impairment, and falls, particularly in elderly or frail patients.

Duration

Short-term use is usually preferred, and in some, tapering may be considered, though in the final stages of life, this is not usually necessary.

 

Investigating - Lemborexant (Dayvigo)

Lemborexant, marketed as Dayvigo, is a prescription medication used to treat insomnia in adults.  Here's a summary of key information about Dayvigo:

 

Mechanism of Action

Dayvigo is an orexin receptor antagonist that works by blocking wake-promoting chemicals in the brain to reduce wakefulness and promote sleep.

 

Indications

It is used to treat insomnia characterized by difficulty falling and/or staying asleep.

 

Dosage

The recommended dose is 5 mg nightly before bed, with at least 7 hours remaining before planned awakening, and can be increased to a maximum of 10 mg based on need and tolerability.

 

Administration

It should be taken right before going to bed with at least 7 hours before planned awakening, and taking it with or soon after a meal may delay its effects.

 

Contraindications

Dayvigo is contraindicated in patients with narcolepsy and severe hepatic impairment, and should not be taken with strong CYP3A inhibitors.

 

Warnings and Precautions

Dayvigo can cause daytime drowsiness and impaired coordination, especially with higher doses or when combined with other CNS depressants like alcohol. It may also lead to complex sleep behaviors, worsen depression, or increase the risk of suicidal thoughts. It is contraindicated in narcolepsy due to the risk of worsening symptoms.

 

Side Effects

Common side effects include sleepiness, fatigue, headache, and nightmares. More serious effects can include hallucinations, suicidal thoughts, allergic reactions, and unusual sleep behaviors.

 

Drug Interactions:

Dayvigo can interact with various medications and substances, including alcohol and certain CYP3A inhibitors. Grapefruit and grapefruit juice should be avoided.

Effectiveness

Clinical trials have shown improvements in sleep onset and maintenance.

User Experiences

Some users report positive experiences with faster sleep onset and improved sleep quality, while others experience negative effects like sleep paralysis, hallucinations, or lack of effectiveness.

Alternatives - EOL Considerations

“Euthanasia and permanent hospitalization present contrasting approaches to end-of-life care, each with its own set of ethical and practical implications. Euthanasia, when legal, offers a controlled and often rapid death, allowing individuals to choose the timing and method of their passing, typically in cases of terminal illness or unbearable suffering. Permanent hospitalization, on the other hand, focuses on providing extended medical and emotional support for individuals who may not be able to care for themselves or whose conditions require long-term management.”

 

MAID: Medical Aid in Dying

https://www.britannica.com/procon/MAID-medical-aid-in-dying-debate

Should Medical Aid in Dying Be Legal?

Last Updated: May 6, 2025

Medical aid in dying (MAID) is also called medical assistance in dying, physician-assisted suicide (PAS), physician-assisted death/dying (PAD), and self-determination in dying. The New York State Bar Association defined MAID as “when a terminally ill, mentally competent adult patient, who is likely to die within six months, takes prescribed medicines, which must be self-administered, to end suffering and achieve a peaceful death.”

 

MAiD in California

Medical Aid in Dying (MAID): A legal process under the California End of Life Option Act for terminally ill adults to request life-ending medication.

Key Requirements

To be eligible for MAID in California, an individual must meet the following criteria:

Be 18 years or older and a resident of California.

Have a terminal disease that is incurable and irreversible, with a medical prognosis of death within six months.

Possess the mental capacity to make medical decisions.

Be able to self-administer the aid-in-dying medication.

 

The Process

The process involves multiple steps and is entirely voluntary for both patients and healthcare providers.

Initial Oral Request

The patient makes a first verbal request to their attending physician.

Consulting Physician Review

A second consulting physician must confirm the terminal diagnosis and the patient's eligibility.

Written Request

The patient provides a signed, written request form, witnessed by two individuals.

Second Oral Request

A second verbal request must be made at least 48 hours after the first one.

Prescription & Ingestion

The physician writes the prescription, which the patient then self-administers at a private place and time of their choosing.  Further information is available through resources like End of Life Choices California or the California Department of Public Health.

 

Euthanasia

MAID differs from euthanasia, which is when a healthcare provider administers a fatal drug, and from passive euthanasia, which is when artificial life support is withheld or stopped (such as feeding tubes and ventilators). Euthanasia is illegal in the United States but legal in some countries, including Belgium, Canada, Luxembourg, the Netherlands, and Spain.

 

Mentally Competent Older Adult

A mentally competent older adult is generally defined as someone who can understand the information relevant to a decision, appreciate the potential consequences, and make a rational choice. This includes the ability to comprehend information, understand its importance, make sound judgments among available options, and consider the potential impact of their decisions.

 

• Comprehend information
• Understand its importance
• Make sound judgments among available options
• Consider the potential impact of their decisions

 

Who makes decisions for a mentally incompetent adult?

Decisions for a mentally incompetent adult are typically made by a court-appointed guardian or conservator when the individual can no longer manage their own affairs. If no prior legal documents exist, a judge determines the need for a guardian based on evidence of incapacity.

Key Decision-Makers and Mechanisms

Court-Appointed Guardian/Conservator

A person appointed to manage personal care (guardian) or financial affairs (conservator).

Power of Attorney (POA)

If designated before incapacity, a chosen agent (financial or healthcare) acts for the adult without court intervention.

Healthcare Proxy/Surrogate

A person authorized to make medical decisions when the patient cannot.

Process for Determining Incapacity

Legal Determination

Only a court can declare an adult legally incapacitated, usually requiring evidence from a physician.

Alternatives

Courts prefer less restrictive options, such as supported decision-making, before appointing a guardian.

Scope

The court may grant full (plenary) or limited guardianship depending on the individual's specific needs. When no family is available, a professional guardian may be appointed.

 

Evidence of incapacity

How is Incapacity Determined? - Vasquez de Lara Group

Evidence of incapacity requires, at minimum, documented, consistent, and recent proof of severe mental or physical impairment that prevents a person from managing their own affairs. It is typically established through medical reports, expert testimony, and accounts of consistent, irrational, or dangerous behavior, rather than isolated incidents of confusion.

Sleep and Suffering

Yes, sustained sleep deprivation can be considered a form of suffering. It leads to a wide range of negative physical and mental health consequences.

 

Elaboration - Physical Health

Sleep deprivation can negatively impact various bodily systems, including the cardiovascular, metabolic, and immune systems. It's linked to increased risk of heart disease, type 2 diabetes, obesity, and weakened immune function.

 

Mental Health

Lack of sleep can severely impact cognitive function, making it difficult to learn, focus, and make decisions. It can also trigger mood changes, anxiety, and even depression.

 

Overall Quality of Life

Sustained sleep deprivation reduces overall quality of life, affecting daily activities, work performance, and social interactions. It can also lead to a greater likelihood of accidents and injuries.

 

Sleep and Mental suffering

Sleep deprivation can cause significant mental suffering due to the impact on cognitive abilities, emotional regulation, and overall well-being.  In summary, sustained sleep deprivation is not just a temporary inconvenience; it can have long-lasting and detrimental effects on physical and mental health, leading to a state of suffering.

 

Can AI determine efficacious medications?

One of the key applications of AI in medicinal chemistry is the prediction of the efficacy and toxicity of potential drug compounds. Classical protocols of drug discovery often rely on labor-intensive and time-consuming experimentation to assess the potential effects of a compound on the human body.

 

Replacing Ambien

Several alternatives to Ambien (zolpidem) can help with insomnia. These include:

 

Prescription Medications

 

Lunesta (eszopiclone): Similar to Ambien, but may have a longer duration of action.

Sonata (zaleplon): A shorter-acting sedative that can help with sleep onset.

Restoril (temazepam): A benzodiazepine that can help with both sleep onset and maintenance.

Dayvigo (lemborexant): A newer medication that works differently than Ambien and may have a lower risk of dependence.

^>Trazodone: An antidepressant that can also be used as a sedative for insomnia. [Trazodone has proven ineffective for Buster with regards to sleep].

 

Over-the-Counter Medications:

Melatonin: A hormone that helps regulate sleep-wake cycles.

Diphenhydramine (Benadryl): An antihistamine that can have sedative effects.

 

Other Options

Lifestyle changes

.

Establishing a regular sleep schedule [Done], avoiding caffeine [Done] and alcohol [Done] before bed, and creating a relaxing bedtime routine [SoSo] can help improve sleep quality.

 

Cognitive behavioral therapy (CBT-I).

A type of therapy that can help patients identify and change behaviors that contribute to insomnia. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective, structured, short-term (typically 6-8 sessions) non-drug treatment recommended as the first-line, long-term solution for chronic sleep issues. It addresses the underlying thoughts, habits, and behaviors contributing to sleeplessness rather than just symptoms. Key techniques include:

 

Stimulus Control: Associating the bed only with sleep.

Sleep Restriction: Limiting time in bed to increase sleep drive.

Cognitive Restructuring: Changing anxiety-inducing thoughts about sleep.

Sleep Hygiene: Improving environmental and lifestyle factors.

 

Natural Remedies.

Some people find relief from insomnia with supplements like magnesium, valerian root, or chamomile tea.  It's important to note that these alternatives may have different side effects and risks than Ambien. It's crucial to consult with a healthcare professional to determine the best option for your individual needs.

 

Natural Sleep Chemicals

 

Adenosine

This neurotransmitter accumulates during wakefulness and promotes sleep. It's also believed to prolong deep sleep. Adenosine is an inhibitory neurotransmitter and metabolic byproduct that functions as a primary homeostatic sleep regulator, accumulating in the brain (especially the basal forebrain) during wakefulness to increase "sleep pressure". It promotes sleep by inhibiting arousal systems and, once asleep, helps prolong deep (slow-wave) sleep.

 

Melatonin

A hormone that regulates the sleep-wake cycle and can be used to help with sleep disorders like jet lag or shift work.

 

GABA

An inhibitory neurotransmitter that helps reduce brain activity and promote muscle relaxation, especially during deeper sleep.

 

Chemical Sleep Aids (Medications)

 

Benzodiazepines

These can be effective for short-term sleep problems, but long-term use can lead to dependency, memory impairment, and tolerance.

 

Antihistamine

Some, like diphenhydramine (Benadryl), are used in over-the-counter sleep aids, but can have side effects like daytime drowsiness, cognitive impairment, and potential risks for older adults.

 

Off-label use

While certain medications (antipsychotics, anticonvulsants) are sometimes used off-label for sleep, there's less data on their safety and effectiveness for sleep disorders.

 

Long-term Risks

Interference with Natural Sleep-Wake Cycle: Prolonged use of chemical aids can disrupt the body's natural ability to regulate sleep, potentially leading to dependence.

 

FYI - Disrupted natural ability to regulate sleep – Not Applicable

A disrupted natural ability to regulate sleep often manifests as narcolepsy, a chronic neurological disorder where the brain cannot properly control sleep-wake cycles. It involves a loss of hypocretin/orexin, essential neurochemicals for maintaining wakefulness. Key features include excessive daytime sleepiness, sudden sleep attacks, and uncontrollable sleep-wake transitions.

 

Tolerance and Dependence

The body can develop a tolerance to sleep aids, requiring higher doses to achieve the same effect, which can lead to dependence.

 

Side Effects

These can vary depending on the specific chemical, but may include drowsiness, memory problems, and cognitive impairment.

 

Potential for Long-term Health Issues

In some cases, long-term use of certain sleep aids may be associated with an increased risk of certain health problems, such as dementia.

 

Important Note

If you are struggling with sleep, it's important to consult with a healthcare professional. They can help determine the underlying cause of your sleep problems and recommend appropriate treatment options, which may include behavioral therapies, medication, or lifestyle changes.

 

Lorazepam

Lorazepam (brand name Ativan) is a short-term, prescription-only benzodiazepine used to treat insomnia related to anxiety or temporary stress. By increasing GABA in the brain, it induces sedation, typically taken at a dosage of \(1\{mg}\) to \(2\{mg}\) at bedtime. It is generally recommended for short-term use due to risks of dependency and side effects. 

 

Gamma-aminobutyric Acid (GABA) Deficiency

GABA (gamma-aminobutyric acid) is a key inhibitory neurotransmitter that plays a vital role in regulating brain activity and promoting relaxation. A deficiency in GABA can disrupt this calming effect, potentially leading to various neurological and psychological conditions.

Causes

Genetic disorders: Certain genetic mutations can impair the production or function of GABA. Medications: Some medications, such as benzodiazepines, can deplete GABA levels over time. Chronic stress: Prolonged stress can lead to reduced GABA production.

Alcohol abuse: Excessive alcohol consumption can interfere with GABA synthesis.

Nutritional deficiencies: Deficiencies in vitamins B6, magnesium, and zinc can affect GABA production.

 

Symptoms:

1.     Anxiety and panic attacks: GABA deficiency can increase anxiety and make individuals more susceptible to panic attacks.

2.     Mood disorders:

a.     Depression, irritability, and mood swings can be associated with low GABA levels.

3.     Sleep disturbances:

a.     Insomnia, restless sleep, and nightmares can occur.

4.     Seizures

a.     In severe cases, GABA deficiency can trigger seizures.

5.     Muscle spasms and tremors: GABA helps regulate muscle activity, so deficiency can lead to muscle spasms and tremors.

6.     Cognitive impairment:

a.     Difficulty concentrating, memory problems, and confusion can be experienced.

 

Diagnosis

 

1.     Blood test:

a.     A blood test can measure GABA levels.

2.     Brain imaging:

a.     Techniques such as MRI or PET scans can assess GABA activity in the brain.

3.     Genetic testing:

a.     Genetic tests can identify genetic mutations associated with GABA deficiency.

 

Gamma-aminobutyric Acid (GABA) Deficiency (Continued)

Treatment

Medications

GABA agonists, such as benzodiazepines and valium, can increase GABA levels.

Nutritional supplements:

B vitamins, magnesium, and zinc supplements can support GABA production.

 

Lifestyle changes

Reducing stress

Limiting alcohol consumption

Getting enough sleep can improve GABA function.

 

Therapy

 

Cognitive Behavioral Therapy	Cognitive behavioral therapy (CBT) can help individuals manage anxiety and other symptoms associated with GABA deficiency.
GABA	The prognosis for GABA deficiency depends on the underlying cause and severity of symptoms.

 

Aside - Valium

Valium (diazepam) is a benzodiazepine, a class of central nervous system depressant drugs used to treat anxiety, seizures, muscle spasms, and alcohol withdrawal symptoms by slowing down brain activity. It works by enhancing the effects of GABA, a calming neurotransmitter, leading to sedative, relaxing, and anti-seizure effects. Due to its potential for dependence and misuse, it's typically prescribed for short-term use.

 

Conclusion – In our own words (Partial Bios)

>This study pertains specifically to Keith “Buster” Torkelson, MS.  Buster holds a degree with honors in pathology out of UC Davis.  Buster has been diagnosed many times with behavioral health ailments including: Bi-polar, Depression, Schizoaffective, Sleep Disorder, Psychosis, Anxiety, Panic and Hypo-mania.  Buster was first hospitalized in 1989.  At this time his doctors told him that causes do not matter and that he would never get better.  In 1988 Buster fell ill in association with an immune response gone wrong.  Buster had been depriving himself of sleep in order to make grades since 1982.  This was a risk factor for Buster to develop a sickness or sicknesses.  Centering about health limbo (1993) Buster had a problematic youth,  succeeded working full time, completing undergraduate, interning in food animal population health, completing his master’s, gaining entrance to Vet School, getting sick, returning and making grades in vet school,  serious life threatening episode 1993, entering into recovery,  helping run the family business,  attending CSU Fullerton secondary teaching credential program, making transition to renting a shared room,  4.0 earned at Cypress College, 2012 crash and burn, etc.  The takeaway is: Leverage an early diagnosis and treat effectively with the intent to resolve the issue as measured by gainful employment and education.