Then and Now: Thank you MAOI’s & Lithium!

3 bunnies

 Sunday morning smiles


I’ve had a lazy, Indian Summer-soaked weekend.  As much as I love the springtime, this is my favorite season of the year, bar none. (Plus Halloween is my favorite day of the year!)  

This morning I reflected upon how different my “lazy weekend” was than my lazy weekends of a couple years ago…

In 2012 and part of 2013, “lazy” was my doing virtually nothing during the weekends.  I stayed in bed or on the couch much of the day, feeling depressed, lethargic and hopeless.  There were also my intermittent crying jags during which I unsuccessfully tried to hide from my children.

In contrast, my current “lazy weekend” included:  

Doing laundry, dishes, straightening up the uber-messy house, completing homework with Rilla, cleaning up poop (Lucy most likely ate chicken poo), working out twice, surfing the internet, & watching an illuminating documentary called “Fed Up”.  It’s a film that was suggested by the blogger Bipolar on Fire.  “Fed Up” is so freaky and mind-bending but I’m glad I watched it!




There’s more: I read some of the works of two New Zealand authors: a memoir “All That Glitters” by the Auckland fashion designer/depression advocate Denise L’Estrange-Corbet, and the “The Nutters Club: Helping Nutters from the Inside Out” by Mike King, a comedian/host of the hit radio show “The Nutters Club” with psychiatrist David Codyre.


At Avi’s request, we went on a family picnic at the park, and last but not least, I watched the season finale of the highly intellectual TLC reality show“Long Island Medium”!

I swear, each time I watch it I feel my I.Q. rise a few points! 😉


So what, Dyane?, you may be thinking.  

You might also wonder,

Frankly, I don’t care about your laundry list of tasks – they are kind of boring.  And you are not the intellectual you claim to be when you reveal you’re a fan of TLC reality shows like “Long Island Medium” – aren’t you a college graduate, or so you say? 

This all may be true, although the books and documentary film I mention are worth checking out, as well as Bipolar On Fire’s blog, which is one of my favorites.  Before I forget to mention it, her blog is:

I must also state that “Long Island Medium” is worth a look if you’re interested in psychic mediums and if you want to be entertained and inspired. 

But back to ultimate point of this post – I wouldn’t be doing ANYTHING unless I had my medications at the ready, namely my MAOI (monoamine oxidase inhibitor) called Parnate, (generic name: tranylcypromine – say that ten times fast!) and lithium.  

I’ve written about these meds before, but I’m bringing them up again for any new readers and because I enjoy expressing how I continue to feel grateful for them.  

The combination of the MAOI & lithium made it possible for me to not merely get out of bed each day, but to function and experience joy again.

I had no idea that MAOI’s have been prescribed for treatment-resistant bipolar depression for literally decades (i.e. since the 1950’s I believe) until 2013, when my most recent psychiatrist brought them up.  I found it mind-boggling that no other doctor thought to even mention them as a possibility since I was a textbook case of being med-resistant (I tried well over 20 drugs ) plus two rounds of ECT.


When my psychiatrist suggested I try an MAOI in the fall of 2013, I did a little research on my own. I located two studies done in the 1970’s that would make ANY person with treatment-resistant bipolar depression rob a pharmacy if she had to in order to give an MAOI combined with lithium a try. (If an MAOI is combined with lithium, the two study findings indicated that the lifting of the bipolar depression is much more likely to happen.)  

While I’m by no means “cured” of bipolar disorder, and I have a long way to go in terms of my recovery, you can see how I’m still light years ahead of where I used to be.  Anxiety, and depersonalization/derealization continue to haunt me on a regular basis.  I’m working on all of this stuff with my counselor and on my own, and this work (yes, it’s work) is a full-time job unto itself that unfortunately few people understand.

After an intense Mental Health/Bipolar Awareness week, I celebrate my pills, the teeny tablets I once demonized until I relapsed without their help.  I’m grateful to these remarkable medications for helping me get my life back, and giving me hope again.  I’m on a quest to inform others who have been medication-resistant like me about MAOI’s if they haven’t tried them yet. They don’t work for everyone by any means, but you never know unless you a) know about their existence in the first place and b) give them a try.

Have a good week, dear readers!



 P.S. I have a small favor to ask each of you!   I’ve been honored with a nomination by the

bestselling author Wendy K. Williamson (“I’m Not Crazy Just Bipolar”, & “Two Bipolar Chicks Guide to Survival”)

for the WEGO Health Activist “Best in Show” Blog Award.  I need your endorsements to win!  

Just visit the below link, select the purple tab that says “Endorse Dyane Leshin-Harwood”

and go from there – it takes only 15 seconds to endorse me.  Thank you so much!


34 thoughts on “Then and Now: Thank you MAOI’s & Lithium!

  1. Interesting! I have had terrible luck with SSRI’s and my psychiatrist was discussing the possibility of boosting me with an antidepressant this winter. I’ll have to bring up MAOI’s (after researching them, of course) and see what she thinks.
    I’m glad your life is so much better now, and that you’re able to see that clearly. Sometimes it hard for me to see how far I’ve come.

    • Yeah – I too had NO luck with any SSRI! Don’t get scared off by the fact that MAOI’s are sometimes called “old school antidepressants” – the very word “antidepressant” freaks me out, but I didn’t care at that point…I was so desperate. MAOI’s get a bad reputation as taking them requires food and alcohol/other beverage restrictions primarily due to the need to avoid an amino acid called tyramine, and yeah – I miss things like aged cheeses, fermented products etc., but is the sacrifice worth it? YES! I hope your pdoc is open to the idea…and I’m glad you’ll do a bit of research too. 🙂 Thanks for your kind wishes! I agree with you that it’s difficult to see our progress, but it helps to take a moment to look back. Things will get better for us Pepper – they will! (((hugs)))

    • Thanks L! And I appreciate your “coming out about “Long Island Medium” ha ha ha! I’ve been entering the “Knock and Shock” contest weekly and I want to win so much!

    • You’re welcome!!! OMG – that documentary woke me up! I can’t believe (well, I can) how crazy the sugar industry is….how evil & unethical it is as they don’t want to lose their billions!

      Every single food label I look at doesn’t list the daily % of sugar – that in itself is deeply disturbing and so obvious that the sugar lobbyists etc. don’t want people to know how serious this problem is! :00000000 Sugar is in almost EVERYTHING! It’s probably in my damn meds! 😦

      • I knew sugar was everywhere – I actually read a famous book called “Sugar Blues” a long-ass time ago, but what I didn’t know was how the Sugar Barons control so much, specifically the government, and how sugar is the tobacco of yesteryear, basically – I mean, the way the Sugar Industry demons bullied folks to cover up the WHO recommendation to advise the public to lower their amount of daily sugar intake was so sick – and don’t even get me started about the children. The pain of those poor obese kids with diabetes 2, getting gastric bypass @ 15 years old etc….their suffering & tears tore me apart.

    • I left stuff out – can you believe it? I didn’t want to come across as hypomanic….however, if I’m anything, this is the time of year I slide downward in mood despite my loving the season so much! It’s a precarious month, so I’m using my Sunbox desk light in the morning. After watching that “Fed Up” documentary in horror, and noting how much sugar I’ve really been taking in day after day, year after year, I’m *trying* to eat less sugar, but I’m a massive sugar addict. :0 I know that the amount of sugar I eat must affect my mood way more than I was willing to admit (or realize) before. Wish me luck on that one! 😉

      • I wish you luck, but sometimes we must allow ourselves some sinful decadences in moderation. Chocolate has redeeming qualities, after all. Savor and enjoy rather than eat an entire pint. I use tiny teaspoons I bought at Ikea and scoop small amounts of gelato or low-fat lactose-free ice cream into tea cups to limit my serving size and slow down eating it. Weight Watchers tricks.

  2. Love your post! So glad you found your magic combo! Who knew the power of MAOIs and Li for treatment resistant depression? Also happy to hear you relaxed and did little stuff on Sunday… we writers need days off! I hope you win the award; no one is more deserving than you!

    • I’m SO glad you liked this post!!! I’m hoping to win the Long Island Medium’s “Knock and Shock” contest, although if she showed up at my door, I’d probably pass out! :))) I’m sure the TLC producers would just LOVE that! 😉 I’ve been entering each week, ha ha! You never know…

      Thanks, Wendy, for believing in me enough to nominate me for the WEGO in the first place!!!! Your nomination blurb was so amazing and truly meant the sun, moon & stars to me. No matter what happens, win or lose, I already won after reading that! XO

  3. After college (when bipolar depression hit hard & I was finally diagnosed), I struggled to “get it together”. No one understood how much work it took to just make it through another day. It was a full time job!

  4. Great post Dy. When medications work they certainly do change your life. What a difference between then and now. Your sharing of the details highlights how far you have come and how different the term “lazy” is taken in your case. All the very best!

    • Hey Glenn, it’s your “Seroquel Sister” here! 😉 (I obviously love using that phrase whenever possible!)

      Your incredible blog has also illustrated the power of finally finding a medication that transforms your life into one where you can truly “live”. Thank you for reading this and for your perceptive understanding what this post is all about! 🙂 Cheers! Dy

  5. It’s spring here and that’s not my favourite season.
    The westerlies seem to dominate for most of the year now and when the flowers bloom so do my sinuses. Even one of my bunnies has sneezing fits at this time of year.

    Summers are better here on the east coast because the NE sea breezes take the edge off. Except lately there’s more westerlies during summer too and that tends to make the bush go up in flames and take a few houses with it. And set off my allergies. Dammit.

    I’d guess the main reason they didn’t mention the MAOIs was because there’s so many SSRIs and SNRIs to run through – not to mention various combinations of mood stabilisers to mix and match them with – that they didn’t get around to the ones with all the dietary restrictions and overdose toxicity and stuff.

    Had they told you about the tricyclic antidepressants?

    As you know I’ve decided against the pills. I can afford to ride it out a bit more than most folks so I do. But I reckon for all the hassles of serum level monitoring lithium is probably the only thing they’ve ever stumbled on that’s more likely to help people with bipolar one than harm them. My Nan’s been on it for about four decades and though it’s probably contributed to her dicky heart her using it to circulate blood non-stop for 95 years could be part of the problem too. The warranty’s definitely expired.

    You’re an intelligent adult and you’ve done your research, much of it on your own body and mind. Antidepressants of all kinds can cause problems with bipolar people, including but not limited to mixed episodes, rapid cycling and switching. They’re all pretty much contraindicated now, especially since the STEP-BD trials. Not that it seems to alter prescription habits much.

    But the fact that something doesn’t work for lots people doesn’t mean it doesn’t work for you. That might be more exercise, change of diet, change of lifestyle or situation, psychoanalysis, CBT, meditation or any combination of chemicals – legal or otherwise – that helps you live the way you want to live. After all the time you’ve been living with it I doubt there’d be anyone better qualified to know what works than you.

    But still. Maybe always keep the questions in the back of your mind. “Could I come off this?” or “Am I ready to cut back on that?”

    Probably ain’t none of ’em are good to keep taking forever.

    • Greetings Cabrogal! You must somehow record your sneezing bunny (poor thing) and put it on YouTube! I’d love to see that….although I guess I sound sadistic because it can’t be fun for your poor bunny. I take it back! By the way, I know how awful allergies are – I’ve had them for years and at one point took stuff called Seldane (off the market now – yikes!) so anyway I’m sorry you’ve been affected by the westerlies!

      To answer your question about tricyclics; yes, I was told about tricyclics by my former shrink and he prescribed amitriptyline/Elavil. I took one pill of that stuff and within 3 hours I became acutely suicidal (you may have read my post about this, so please forgive me if this is old news) and I wanted to hang myself on our deck railing with my very thick bathrobe belt.

      I’ll never forget that afternoon for many reasons, but I found the whole thing particularly bizarre because never in my life had I wanted to hang myself. I had wanted to take my own life before, but I was terrified to use the hanging method and I had another way in mind.

      I have a strange theory about why I felt the way I did. The death of one of my favorite musicians (Paul Hester of Crowded House/Enz etc.) had taken place prior to my taking Elavil, and his death haunted me. I couldn’t stop thinking about it. As he hung himself, I may have, somewhere in my brain, wanted to emulate him. Who knows?

      I know you are med-free and you’re lucky to be able to do it! I read somewhere that 10-20% of people with bipolar can live a stable life without meds. I interviewed a doctor who had lived over 10 years med-free and she had been doing great all that time – and I sought her out to guide me so I could do the same thing as her, which didn’t work out. That’s not to say it can’t be done. (By the way, it helps me to read about your Nan’s long-term use of lithium – she’s 95???!!! WOW! It sounds like you have longevity genes in your blood, my friend!)

      You bring up excellent points and thanks for noting that I’m intelligent! (Let’s keep that ruse going! I think your three ***adorable*** bunnies are smarter than I am, but shhhh, don’t tell anyone that!)

      I’ve been reading about recent studies indicating that anti-psychotics shorten life span. I’m sure that none of the heavy-duty meds are good to take forever. I have a great psychiatrist who is the first I’ve seen out of so many pdocs who wants me to eventually lower my dosages and even go off one of my meds.

      I have mixed feelings about it all. “Terrified” is far too light a word to describe how I feel about relapsing. If my meds keep me functioning, I can reconcile myself to the long-term risks of staying on these freaky chemicals….at least for now. Then again, if something awful happens to one or more of my organs as a result of my choice, then I’ll be singing a very different tune.

      I’m just so weary of it all. I used to be a nature girl – I even had a crazy stint as a vegan, I drank no coffee for years, (which is my lifeblood) , and I was all about natural & organic products. Then I went to the dark side and put all kinds of powerful pills into my system containing chemicals that most doctors admit they don’t fully understand whatsoever (freaky!) AND no one knows how the newer meds (i.e. my Seroquel/quetiapine) truly affect our bodies over the next 20+ years of taking them.

      I watched a fascinating documentary that I think you’d find interesting too – I don’t know if you can get it over there. It was done by PBS a few years ago and it might be available online. It’s hosted/written by the amiable “Happiness Expert/Harvard psychologist/bestselling author” Daniel Gilbert. It’s called “This Emotional Life” and I watched all 3 DVD’s.

      What stayed with me the most was the DVD that discussed depression. Dr. Gilbert interviewed a neurologist who did a groundbreaking study. He examined depressed people’s brains, and he showed how their depression actually damaged parts of their brains. After the subjects took antidepressants for just 3 weeks, they started to grow additional brain cells. Now, for all I know (this is the crae crae in me talkin’) the study could be a hoax funded by BigPharma to sell more meds, but I believed it hook, line and sinker. The same effect was shown with ECT patients’ brains and Big Pharma doesn’t make $ off that. I felt better watching that part because you know I had ECT.

      At the end of the day, to tell you the truth I just want a frickin’ cure. It’s simplistic thinking…I know that. And it probably won’t happen, although life is so nutty that one never knows what’s round the corner, eh? Moreover, I know many folks with bipolar don’t want their mood swings taken from them for they could lose their creativity. All I know for sure (sorry to sound like an Oprah Parrot – caw caw!) is I don’t want to feel suicidal again and I don’t want to be depressed for years on end. I’ll eat banana slugs raw every day if scientists discover their neon yellow flesh could prevent bp depression. Slug sushi! 😦

      • I know you are med-free and you’re lucky to be able to do it! I read somewhere that 10-20% of people with bipolar can live a stable life without meds. I interviewed a doctor who had lived over 10 years med-free and she had been doing great all that time

        I wouldn’t imagine many doctors would call my bipolar stable. Rather than trying to flatten it out I’ve been primarily concerned with learning to ride the highs and lows in a way than minimises the damage they do to me and those around me. I think by and large I’m doing pretty well these days.

        Nor am I drug free. When I can afford to I use cannabis to moderate my manias (keeps me eating and helps me sleep) and to deliberately lower my psychosis threshold. When I’m hypomanic or manic my psychosis threshold is low anyway and a brief cannabis triggered psychosis (rarely more than a couple of hours once I stop smoking) in a safe, familiar place often ‘breaks’ the mania and allows me to start calming down again. Sure beats having one unexpectedly in a shopping mall.

        I don’t see bipolar as a disease or disorder. It’s a dangerous gift. I’m still learning how to use it.

        It sounds like you have longevity genes in your blood, my friend!

        Strangely it’s the Aboriginal side of my family (my Mum’s side) who are long lived, which is a bit counter to demographics in this part of the world. But there’s a lot of nasty stuff on that side I’d rather do without too. The allergies for instance.

        Then I went to the dark side and put all kinds of powerful pills into my system containing chemicals that most doctors admit they don’t fully understand whatsoever (freaky!) AND no one knows how the newer meds (i.e. my Seroquel/quetiapine) truly affect our bodies over the next 20+ years of taking them.

        Yeah, it’s a bit of a worry once you get past all those cute graphics of happy little neurotransmitters bouncing around the synaptic gap and realise that medicine actually has very little idea what they’re doing with these molecules.

        A big concern of mine is the sudden emergence of “bipolar children” in the last ten years or so. For the century since Emile Kraepelin first defined ‘manic-depression’ there’s been broad agreement among mental health professionals that it’s not a valid diagnostic criteria for children (some suggest half jokingly that all kids are bipolar). Then a few industry ‘key opinion leaders’ get together with carer groups and viola – an epidemic of pediatric bipolar disorder from nowhere. All treated with drugs we know have a more radical effect on developing brains than the occasional alcohol binge or joint that parents so often agonise about. But it’s gonna take decades to determine the severity and extent of the effects.

        I wonder if it’ll be another issue like lead in petrol where they never even realised it was causing a world-wide violent crime wave until they’d phased it out again.

        When I was a kid I had a chemistry set. Kids these days are chemistry sets.

        He examined depressed people’s brains, and he showed how their depression actually damaged parts of their brains. After the subjects took antidepressants for just 3 weeks, they started to grow additional brain cells

        Yes, the neurogenesis theory of antidepressants. I’ve looked at that one as well as the autoimmune theory and several others. As you’d probably know the serotonin theory was thoroughly debunked by the late 1990s but you’d never know it from the publicity.

        It won’t go into all the problems with SSRI studies here. The publication bias, the data slicing, the multiple surrogate endpoints (Particularly relevant in this case. Despite the glib statements and flashy fMRI graphics you can’t directly measure cell death and growth in the brain and even if you could not all cell growth is good – just ask a neuro-oncologist or a survivor of one of the trials that injected stem cells or foetal neurons into the brains of Parkinson’s and MS patients). A lot of the problems would be fixed by a compulsory trial register and Ben Goldacre – who campaigns for one – uses the shonky reporting of SSRI studies as one of his main arguments.

        But you’ll also find very similar neurogenesis claims made for ECT and I think that’s a big hint as to what’s happening here.

        We know ECT traumatises the brain. Like other shock therapies such as insulin coma that’s what it’s supposed to do. And as with any other part of your body, traumatising the brain stimulates repair systems and new cells are formed. But as with scarred faces, lung cancer and liver cirhossis, not all new cells are desirable.

        What the neurogenesis theory of depression suggests to me is that anti-depressants might traumatise brain tissue. Whether for good or ill looks to me to be six of one, half a dozen of the other.

        Maybe it works sometimes for some people. Kicking a defective TV can sometimes fix it too – even if it irretrievably damages as many as it fixes. You don’t tend to hear about the latter so often though.

        In fact I think most of the ‘progress’ in biopsychiatry has been about finding ‘gentler’ methods of kicking the TV that are less likely to kill the patient outright. By and large they haven’t got a clue what they’re doing and most of their theories are retrofitted to pre-existing practices so as to justify them.

        But what STEP-BD and STAR*D showed pretty clearly is that antidepressant use is a strong predictor for medium to long term deterioration in bipolar patients. That’s not to say they cause it, nor that they don’t help some people while possibly harming even more. But it’s about as good as drug trial evidence gets and I’m not about to start trying to buck those odds in my own body.

        If you want to have a cold, hard look at the evidence for antidepressants in general you can’t go past The Emperor’s New Drugs by clinical researcher Irving Kirsch. I guess the main problem I have with theories as to why antidepressants work is because on the objective evidence they mostly don’t.

        But if you want to know if they work for you, you have to ask yourself. Ain’t no-one likely to know better.

        At the end of the day, to tell you the truth I just want a frickin’ cure.

        I wouldn’t be holding my breath. They’ve been at it for well over a century now and they still haven’t even got consistent, reliable diagnostics much less a cure. And if you believe their own figures it’s now far more widespread than when they started.

        I reckon as long as they keep defining it as a cluster of subjective symptoms but imagining it as a discrete objective disease they’re going nowhere. They’ve been going there for quite a while.

  6. Hi there! I really needed to find this post. I finally have some internet (I run to my sister’s house for some average speed internet just to post a bit. I recently blogged on me overcoming a 3month bout of depression. It was brought on by different external factors, but getting the right mix of meds has been life changing. I can breathe! Have a look please, and congrats on the accolades 🙂

    Power to you,


    • Hi there Yvette! I’m so glad you wrote a comment, & I immediately followed your blog and tweeted about it too! 🙂 I’ll catch up on your blog posts – I’m so sorry you suffered for 3 months with the evil depression. 😦

      Thank God you are feeling better and that the medications are helping you. Believe me, I know that feeling of gratitude when the meds kick in. I’ll stay in touch with you and I look forward to your posts – please keep writing!!!!!

      (((hugs))) to you, Dyane

      • I got so excited when I read your replies, I didn’t even know how to reply. Thanks for well wishes and words of encouragement Dyane. Coming from you, it means a WHOLE lot. Regarding the writing, I started my initial blog to document my feelings in poetry and soon it just became just my voiced opionion on different subject matter. Then I started the bipolar blog to rid myself of the ‘restriction’ I felt not being able to talk about bipolar infused topics.but I always get stuck; I don’t know if it’s thebipolar talking. I ask myself why should I keep writing? I love to write. But I’m scared to write. What if it’s not me writing? What if I’m breathing life into the illness and not life into my spirit?
        Hoppe it makes sense!
        *warm hugs*

    • I hope you get this reply, dear Yve, as I’m still not sure about how WordPress works! I just wanted to thank you for your lovely comment below…I’m happy to keep encouraging you because you deserve it and you appreciate it!!!

      Yes, your comment made total sense to me. For a while it seemed that all I could write about was bipolar-related material, but then I needed to write about other things too.

      I love the image of you breathing life into your spirit instead of your illness!!!!! I want to do the same thing. I get scared to write sometimes….the fear comes and goes. You want to write about topics that ultimately restore you whenever possible or serve as a way for you to get something out and into the open. It’s not easy, even when things are flowing and the fear is gone. In any case, I’ll keep reading anything you post! Now I’m the one not making much sense, but I think you are awesome and I *know* that makes the most sense of all!

      Take good care and big hugs back at you!!!!!!!!!!! Dy

      • Thanks so much Dyane. You’re amazing, dare I say it amaze-balls (I said it). Thanks for the inspiration. Again, it means so much coming from you. I hope to grow, as mother, wife, bipolar through this entire procss. And hopefully touch the lives of many who could be struggling too.

        *virtual hi-five*

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  9. I’m so glad I read this–much of my postpartum years were like this. I did just enough to keep the kids alive, but I was completely disconnected and living in my head. Writing helped bring me out a little, but only the current medication and therapy together have helped me stay CONNECTED to my kids, and to work through the dark spells without hiding in a room to cry. We are fighters, you and I. We just needed the right weapons to get the upper hand. 🙂

    • I can’t begin to thank you enough for this comment, my fighting buddy & kindred spirit.
      I’m deeply honored that you read this blog – your comments/perspective/friendship
      are some of my very biggest joys that I’ve received from blogging.


      • (shuffles and blushes) Well, shucks. I’m the one to thank you for reaching out! I’ve always been one of those to hang out at the edge of the room, never sure where to sit and infringe upon the already-established group. Thanks for lookin’ my way and offering a seat with the Cool Kids. xxx

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  12. Hi, this is a bit late in the day, but….
    What does Lithium do for you really? I have been off, on and at different doses. I can’t really track any impact at all. It’s been a while, but assuming you have even more years to comment on!

    • Hi there! I’m on blogging hiatus but I was notified of your 2 comments & I couldn’t resist attempting to answer your question.

      Lithium works for me in terms of keeping mania at bay. I take the first generation antidepressant tranylcypromine (MAOI class/ /monoamine oxidase inhibitor) and I could become manic from taking that antidepressant alone. So lithium is doing double-duty.I

      I take 900 mg/night now. I’d like to go lower just because of the cumulative effects it is most likely having on my liver/kidney/God knows what, but my blood level is at the very end of the therapeutic range. if I lowered it, well I don’t want to rock the boat.

      I’ve gone all the way up to 1575 mg/day per my ex-psychiatrist’s prescription, and I shook like a leaf and my hair fell out. I wrote more about it in my book, but that’s the gist of it. I hope I answered your question – please feel free to ask for any clarification! I’m sorry you have to go through this malarky as well. It sucks!

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