# Pupil size



## revuptheglory (Feb 14, 2016)

My pupils are significantly bigger with dp. Anyone else?


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## Guest (Apr 24, 2016)

Its most likely from being anxious. Pupil dilation is a symptom of anxiety.


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## revuptheglory (Feb 14, 2016)

fishfried2 said:


> Its most likely from being anxious. Pupil dilation is a symptom of anxiety.


Yea that's the only explanation I've come upon


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## Billy D.P. (Apr 12, 2016)

Yep. Used to be a lot worse. Getting better as I do. If there's not a poll on this you, or somebody, should make one. I know this is really common with HPPD. It'd be interesting to see the relationship to DP as well.


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## Visual (Oct 13, 2010)

revuptheglory said:


> My pupils are significantly bigger with dp. Anyone else?


Pupil response is known to be affected by emotional response http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612940/

Mydriasis is not uncommon in DP and HPPD. When it is constant, it isn't likely to simply be just anxiety (kind of hard to check pupil size while someone is sleeping - a non-anxiety state, lol)








If it is just emotions, how does one explain Anisocoria? https://en.wikipedia.org/wiki/Anisocoria Are we to then conclude that the right brain is 'happy' and the left hemisphere is 'anxious' (or visa versa)? Colin Ross would love that!








What is the common denominator is the hypothalamus which is "Central Control of the Autonomic Nervous System" http://neuroscience.uth.tmc.edu/s4/chapter03.html It is affected by emotions, drugs, and various states of brain function.



Billy D.P. said:


> Yep. Used to be a lot worse. Getting better as I do. If there's not a poll on this you, or somebody, should make one. I know this is really common with HPPD. It'd be interesting to see the relationship to DP as well.


Drugs affect pupil size but the effect should only last for the duration of the drug. "The presence of miosis and mydriasis may also indicate opioid and anticholinergic medication toxicity, respectively" http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614410/ Yet plenty of HPPDers report enlarged pupils from opiate use or other drugs concurrent with the presentation of HPPD.

Over the years have observed some improve from mydriasis or anisocoria with Sinemet, a dopamine increasing medication (a neurotransmitter involved in ANS activity). And recently with thiamine cocarboxylase. The latter was particularly unexpected but thiamine deficiency is known to cause mydriasis (there is another thread discussing thiamine in detail).

A poll would be interesting ... if a lot of people would participate.

Also one including ADD/ADHD and medication responses affecting both anxiety and pupil sizes. With ADD, people often 'calm' with dopamine increasing meds - which to some is paradoxical since dopamine is a stimulant. So a parallel to 'dopamine-responders' and HPPD.


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## Surfer Rosa (Nov 27, 2015)

I was getting me some PTS, and the guy with me said my pupils were enormous.


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## Visual (Oct 13, 2010)

Surfer Rosa said:


> I was getting me some PTS, and the guy with me said my pupils were enormous.


What is PTS? Googled it and first got Post-Thrombotic Syndrome.

Then got Porn Torrent Syndrome ... maybe that's it! Pupils enlarge when sexually attracted. We are just stuck in that state but ashamed to admit it ... Freud would be so proud! It explains brain-fog (gaga), blurry eyed, insomnia, cognitive problems, detach feelings, floating - all the symptoms we're so fond of ... even married too (pun intended)

This brings back the days of an old dating service *Phant* inspired. And just as he has returned, so too this service ... a bit of an eye-opener (a pun). Warning, it is a bit out-dated (another pun) http://www.dpselfhelp.com/forum/index.php?/topic/28968-dating-sites/


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## Surfer Rosa (Nov 27, 2015)

Visual said:


> What is PTS? Googled it and first got Post-Thrombotic Syndrome.
> 
> Then got Porn Torrent Syndrome ... maybe that's it! Pupils enlarge when sexually attracted. We are just stuck in that state but ashamed to admit it ... Freud would be so proud! It explains brain-fog (gaga), blurry eyed, insomnia, cognitive problems, detach feelings, floating - all the symptoms we're so fond of ... even married too (pun intended)
> 
> This brings back the days of an old dating service *Phant* inspired. And just as he has returned, so too this service ... a bit of an eye-opener (a pun). Warning, it is a bit out-dated (another pun) http://www.dpselfhelp.com/forum/index.php?/topic/28968-dating-sites/


O man that was a pretty elaborate and multi-layered gay/porn joke.

It's post-traumatic stress, without the disorder part. I think it's not a very valued term. Acute stress is used much more instead. I was avoiding using another diagnosis on myself, but it looks like acute stress describes it.


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## Visual (Oct 13, 2010)

Well not quite the intent ... but that is the way it often is with humor. Probably just adds to PTSD.

BTW, thanks for the clarification. There seems to be so many terms for anxiety and stress. Its exhaustive. ASD, PTSD, ... Google gets useless sometimes. But unfortunately doctors aren't as helpful as one would hope.

Now for something really completely different ...








Back to pupil size. Dr Abraham (a researcher of HPPD) uses measuring pupil size and response in diagnosing this disorder. And has suggested more research into it as a marker.

So it comes back full circle that having changes in pupil size cannot just be dismissed as anxiety, anger, attraction, or any other transient factor.


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## Surfer Rosa (Nov 27, 2015)

I'm frustrated with myself, not with you. Don't sweat it. Do you have PTSD? That one sucks pretty bad. I imagine it's like having ASD that doesn't go away. ASD felt more like having a disease in my brain than anything else I've experienced.

About the pupil dilation, I was just naming scenarios that might be of interest. Another time that my pupils were big and dilated was when I was feeling overwhelming feels of love (like you said). It wasn't just arousal, so porn is sort of off the table here. Does LSD dilate pupils? Ecstasy does.

The only other time I remember having the same feeling in my eyes was when the eye doctor splashed this yellow chemical into my eye to make the pupils dilate. I'm not sure if this is just my imagination, but it felt as if the tiniest draft in the room would hit my eyes like the wind.


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## Visual (Oct 13, 2010)

One doctor wrote I have PTSD. Faced death several times as a child. Found mom dead at 15. When the visual problems started, felt like was dying - but after nine years, its a really slow death, lol.

Flashbacks are supposed to be a hallmark of the diagnosis. The only times I've had flashbacks was for a few weeks after mom. And then after putting my hound down a couple years ago. For about a year would actually flashback to her struggle to live and heart racing ... then slowing as the vets injections did their thing. For some reason became very attached to that dog. While no longer 'flashing', still suffer grief ... even as typing this.

But until 2007, eyesight and visual perception was stellar ... even doctors would comment about it.

Many speak of DP as from anxiety. I lived anxiety most of life without DP. Now, mainly from being tied of being a slave to the fear of death, have accepted it might be a relief to no longer exist. With that fear subdued, it has opened up an enriched life. Even in spite of having disappointing health.

In some regards, the worst suffering is being isolated. Friends are very busy making a living and raising their family - the whole rat race. So it becomes impractical to be friends. All the more so since by evening am very tired and that is when people get together.

Ironically, many people are lonely and fearful. Further is the irony of improved communication with the internet ... yet actual reduced physical (as in being in the same room) contact. It isn't healthy, yet its become 'practical' to live this way. And look at our disorders ... how many people near us are there to meet with? Probably more than we know ... but we don't know and connect just on forums.

Since am mid 50's, have seen dramatic changes in society. The civil rights, Vietnam, nuclear arms race ... massive changes since Kennedy was president. Life is very different now. And people are isolated, even when not sick. In the 1950s people would visit during the day, have tea, etc. More working in the 60s led to just the weekends. And the phone helped stay in contact without being there. Then email, then text - communication in short cryptic pieces. Anyway, so much for history ...

Don't be too frustrated with yourself. One can only work from where they are. Life is not just a journey, it is a puzzle. It takes effort to figure out what is and isn't right and how to deal with it. Even the whole topic, is it psychological or neurological? Just work both ends. Sometimes one gets tired of being Sherlock Holmes. Just take breaks.

What are your diagnosis?


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## illmatic (Apr 16, 2016)

A close friend of mine commented that my eyes have changed. He compared it to that of recovered heroin addicts and said it looked like I have "seen the other side" lol. This freaked me out of course. But then I found out that this is a common symptom with people who have constant anxiety. It has already gotten better now that I am not having anxiety and panic 24/7. And anyone else I have asked says I look normal just like before DP.


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## sunjet (Nov 21, 2014)

As long as they react to light and your vision is ok, pupil size is not a real problem.

I have physiological anisocoria, around 3mm difference.

When you're anxious, your sympathetic nervous system is fired up and pupils open up to get more light for being able to flight or fight.

Don't worry


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## Visual (Oct 13, 2010)

Have you always had anisocoria?

Anisocoria is completely harmless unless extreme. And even then it is only an indicator. Some are just born that way and live just fine.

Mine first showed up after neurological problems. Along with it was a phantom, pseudo anxiety that was crippling. Also, when sitting in a room at 68°F or less, heart rate was ~60bpm. But in a room that was >70°, heart rate would double to 120bpm. At the time it was thought to be just anxiety. Gabapentin resolved it and within a week was taking 1800mg/day with no side effects - a win-win.

Over the years, worked the dose down to just 300mg before bed. Often eyes would be slightly off, sometimes with increased anxiety but often not. And when the heart would race due to heat, there was no anxiety at all.

Recently, eyes normalized upon taking thiamine cocarboxylase (a long winded thread elsewhere). Perhaps sometime will stop the gabapentin ... maybe its no longer needed.

Curiously, my mom suffered occasional anisocoria. It was more extreme than mine and she always felt horrible and looked distressed. Now understand what she was going through.

It would seem that this was inherited from her. Because it came with problems, and had these associated responses, now use it as an ANS marker.


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## gmriefler (Nov 4, 2008)

Mine were normal I guess, but one the pupil of my left eye was a bit different than my right eye (could see it in pictures when my left eye would be red (from retina imaging in back of the eye due to more dilation) while my right eye appeared "normal".

OMG- I've noticed that Geodon has increased my pupil size big time...its kinda freaky, almost as if I got dilated in the eye doctor's office.

I wouldn't worry about it too much!


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## Surfer Rosa (Nov 27, 2015)

I deleted my rant. Sorry you had to witness that event, Visual. That is beyond fucked up. Maybe we just depersonalize and lose focus when we are in a state of stress now? I mean, that would definitely be understandable in your case.

Me, I just have a dramatic personality. The layman (or shit tier professional) may interpret that as "not being a real thing", but it's a set of maladaptive behaviors, real personality defects. These traits have made me more succeptable to stress and abuse than the average person.


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## Gadgirl (Feb 5, 2016)

I constantly look like im on drugs my pupils are like saucers, but they respond to light


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## Visual (Oct 13, 2010)

gmriefler said:


> Mine were normal I guess, but one the pupil of my left eye was a bit different than my right eye (could see it in pictures when my left eye would be red (from retina imaging in back of the eye due to more dilation) while my right eye appeared "normal".
> 
> OMG- I've noticed that Geodon has increased my pupil size big time...its kinda freaky, almost as if I got dilated in the eye doctor's office.
> 
> I wouldn't worry about it too much!


Its not surprising for meds that alter dopamine to affect pupil size. What other meds are you on .. or have you taken?



Surfer Rosa said:


> I deleted my rant. Sorry you had to witness that event, Visual. That is beyond fucked up. Maybe we just depersonalize and lose focus when we are in a state of stress now? I mean, that would definitely be understandable in your case.
> 
> Me, I just have a dramatic personality. The layman (or shit tier professional) may interpret that as "not being a real thing", but it's a set of maladaptive behaviors, real personality defects. These traits have made me more succeptable to stress and abuse than the average person.


Must have missed your rant ... or it went over my head (same thing sometimes).

Plenty of people are frustrated and rant. Part of the support here. And one can clearly see from my plethra of posts that there are plenty of maladaptions and defects, lol.

Lately have had to swallow lots of benadryl because of a dermatological issue. Talk about brainfog and instability! However last night took a wack of glutathione powder and feel better today. One should not underestimate the effects on the head of intermediate stuff that can get backlogged.


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## Surfer Rosa (Nov 27, 2015)

"Intermediate stuff that can get backlogged"?

To be more clear, my apology was about what you witnessed as a teenager. My rant was bad, but not that bad. I felt sort of self-centered making a long post about my personality issues, after you shared such a shaking story about how you, in a round about way, ended up on DPSelfHelp.

That, and I was saying it's really no surprise that you have depersonalization. It would make sense for someone with PTSD to feel depersonalized. There at least appears to be a pretty big difference between the DPD and "depersonalization symptoms" people.

Benadryl may be okay on le brain, but antihistamines are definitely not excellent for clarity, you're right. Those shits also make me tired and thirsty. Some people act like antihistamines are nice, but I realy don't know about that. Seroquel, Remeron, heroin all have antihistamine effects. Benadryl and Vistaril can have some minor body anxiolytic effect, but it's not really a particularly pleasant one.


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## Visual (Oct 13, 2010)

"Intermediate stuff" - is refering to intermediate metabolites ('free radicals', 'oxidative species') that occur during the normal biological metabolic processing. But for various reasons they can build up and cause damage - exactly as oxygen changes iron to rust https://en.wikipedia.org/wiki/Oxidative_stress

Don't worry about feeling self-centered. Illness does that. DP does that. Anxiety does that. Its human. It helps to pull out of self in what ever way one can find - sort of the mental health equivalent of the joke, "Men with nagging wives live longer - or at least it feels that way"

I don't have DPD. Am somewhat socially-autistic. Both situational and neurological. Actually found this forum searching for info for a visual symptom - flickering in low light. Participation grew from that. Probably don't belong here, don't belong on HPPD forums, ... but there are many cross symptoms between diagnosis. Better to crash the party then remain isolated. Might get kicked out but think of all the free booze and babes.

Its helpful to communicate with others. And to learn to stop blaming self for everything that is wrong. Yea, some of us have done some dumb things, so has everyone. Isolation and suffering tends to lead one to blame themself. Its like kids blaming themselves when their parents divorce ... its not true.

As for long posts about self. Stuff gets bottled up. Also, its kind of meaningless to mumble, "Got anxiety". Texting is prime example of how much is lost in brevity. And how does one wrap up a life in a paragraph? DPD would be "Grunt" - and no, not the urban translation, the caveman translation.

Sounds like you are getting help and making progress. Do you have an intro with your story?


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## Guest (Apr 29, 2016)

How does one wrap up

A life in a paragraph?

A caveman would grunt

A haiku


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## Surfer Rosa (Nov 27, 2015)

Truth be told, I am sick of my story. They didn't write the first half very well: no strong characters, and the setting was all mixed up. Here's hoping it pulls together in the second half. *Clank.* Just kidding, I am a pretty sober person, stoned off my ass on life.

I see the lights flicker in low-light settings too, usually out of the corners of my eyes, but I'm not sure what that is either. Maybe it's the mouth of the void. They say it is nothing, or like, "Not a phenomena that people normally complain about besides in retinal detachment." Maybe it's very minor retinal detachment, and maybe everyone with a family history of ocular degeneration gets it? I'm guessing at this point.


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## Visual (Oct 13, 2010)

Phantasm said:


> How does one wrap up
> 
> A life in a paragraph?
> 
> ...


Guzuntight!



Surfer Rosa said:


> Truth be told, I am sick of my story. They didn't write the first half very well: no strong characters, and the setting was all mixed up. Here's hoping it pulls together in the second half. *Clank.* Just kidding, I am a pretty sober person, stoned off my ass on life.
> 
> I see the lights flicker in low-light settings too, usually out of the corners of my eyes, but I'm not sure what that is either. Maybe it's the mouth of the void. They say it is nothing, or like, "Not a phenomena that people normally complain about besides in retinal detachment." Maybe it's very minor retinal detachment, and maybe everyone with a family history of ocular degeneration gets it? I'm guessing at this point.


'Clank' is an excellent description of our issues ... catches the subtleties better than 'grunt'.

Don't know about 'stoned' as I've never been so - funny, one doctor looked at my wife, shook his head and said, "damaged like drug abuse yet never got to feel high ... tragic". But I can describe it as the disoriented feeling of having drunk too much ... but without the euphoria.

'sick of my story' - AMEN. Not only is it difficult to describe these 'states', it can be long and detailed. People don't understand and one gets tired of explaining. A couple years ago saw a different ophthalmologist. Tried to explain stuff but emotions started getting in the way - so it just came down to, "check the eyes to make sure they are still healthy".

BTW, has anyone else seen My Beautiful Broken Brain? Its about a lady who had a stroke. Good info and a little bit close to some of us.

For me, flicker in low-light settings is an absolute marker for low dopamine levels. Have you tried any meds that increase dopamine? What meds are you on? Or tried?


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## Surfer Rosa (Nov 27, 2015)

I think I first noticed the flickering lights when starting Abilify. The psychiatrist said that was not a usual side-effect. It has come and gone ever since. It persisted for months back then, but now it just happens occasionally. I might have started seeing it again due to Seroquel, but I can't say. The antipsychotics were just obvious attempts to sedate me on a deep level. The first set of prescibers gave it to me because my mom complained about my behavior, and the second set gave them to me because I was too upset to sleep.

At this point, it mostly does not happen, and I am not taking an antipsychotics.

What makes you say that the flickering is critically low dopamine? You may be right. I have to get my dopamine up. I remember surges of dopamine feeling like "cures". I could try exercise, improving diet, perhaps restless leg medication, socializing more...The list probably goes on. Maybe my brain is not particularly "special" or deficient in this way; maybe this is just a natural response to not finding things to do for years, and being stressed.

I do subscribe to the idea that I have a shitty little amygdala. I share too much in common with people who have that issue, but stoicism helps.

What you said about not trying to explain brain problems to doctors makes sense. If doctors could have a comprehensive view of what is happening to our brains, they would be curing disorders like Schizophrenia, Depression, Alzheimer's, and maybe even stroke. I am in the same boat as you, asking them to deal with whatever part of the body they chose to be assigned to, and moving on.

It's not really a comfort that my tendons, my bones, my blood and so on all seem to be working without issue. The brain is really the seat of it all.

I do believe in not necessarily labeling everything as a disorder. There are societies where people with dissociative and psychotic disorders are just considered different and don't necessarily function with more or less misery (or even delusion) than the average person. Maybe having a certain type of brain (small amygdala, differently working receptors) is not necessarily a bad thing. You could definitely say it's bad for reproduction and productivity, but philosophically speaking, life with flawless reproduction and peak productivity would be pointless and absurd.


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## Visual (Oct 13, 2010)

Both Abilify and Seroquel lower dopamine activity (receptor antagonist, partial agonist, inverse agonist). As for critically low, the problem is more a matter of objectives. It seem in my case there are ideal levels for vision yet others for sleep and others for anxiety, etc. Over time there are various markers that I use to adjust meds accordingly. Prefer to work with relatively benign ones rather than the subjective, how-anxious-am-I or how-clear-headed-am-I. The latter ones can tend to drive one buggy whereas others are more emotionally neutral. There can be a thin line between managing a condition and OCDing it. DP, DR, HPPD, depression, etc..., aren't as simple as a finger prick to check glucose levels.

So you aren't taking these meds now? They can calm, but they will blunt and even DP a person in the process. Are you taking anything currently?


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## Surfer Rosa (Nov 27, 2015)

Yeah. Like I said, they were relatively careless attempts to sedate me, one time because my mother asked, and another time because I asked. My mother and I were having serious conflicts, and I was just staying awake until collapsing on a 36 hour routine. I'm sure a "hypnotic" would have been a better choice, but there's that whole "prescribing benzos" stigma, due to people not being properly informed (or convinced) about the prescription guidelines.

Why are you particularly focused on your vision? If I don't like my frames, I don't wear my glasses, my numbers for astigmatism were like 6 or 7.

Thanks for restating the thing about antipsychotics lowering dopamine. That is obvious, but for some reason I wasn't clear on it. Again, why do you find that to be more than a coincidence? It's definitely possible, but maybe there are studies on what troublingly low dopamine is like? I guess they skip right over people complaining about eye-symptoms, to focus on people who have been unfortunately made zombies by overmedication. I'm hesitant to let them give me eye symptoms, and I'll never let them zombify me. That is pretty irrelevant though, since the antipsychotics have never helped much.

I agree about managing a condition while having anxiety becoming OCD-esque. I recently got more free time, and instead of being happy like I was, I became totally exhausted and stopped enjoying my hobbies and time-sinks. It's not quite OCD though, since I basically realized this unconsciously and stopped on my own. Hopefully you are cutting back too.

Knowing what I'm supposed to do for BPD with the DBT and the bla bla bla bla mindfulness, it's better to just let it sink in unconsciously and not focus too much on it. I'm finding myself acting better and making better decisions for my health when I'm calm, but I need ways to handle myself when I become overly stressed or angry. Maybe the lessons are working in those scenarios though. Someone was pretty much being ignorant and fucking my sleep up in the other room, and I just politely asked them to stop, complained to my roommate, and said that I would make a case of it if after waiting a while for it to stop on its own. That's better than old me.

So maybe you're right, about learning the lessons in therapy and moving on to focus on greater things.


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## Visual (Oct 13, 2010)

*Why are you particularly focused on your vision?*

That was 90% of my symptoms. Used to have fantastic/flawless vision - sharp like an eagle. Then it went dull, fuzzy, halos, starbursts, eyes hurt, lost depth perception, and at its worst had forms of blindness - slow 'frame-rate' and unable to understand what was seen (even in times of clear vision, it lost meaning ... began walking with one hand in front of face and the other at side so as to protect self while walking). Truly bizarre.

The emotional stuff was less dramatic - although going functionally blind is not known to be calming. Never went DP, just DR ... and it kind of depends how they are defined. But people talk of being numb, existential crisis, and other features that aren't really issues for me. So, to a significant extent, don't really fit in this forum.


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## Surfer Rosa (Nov 27, 2015)

I think only a few of us "belong here" in that sense, particularly the senior members with an interest in DPD research. So you think those eye symptoms are low-level dissociation? I have had similar symptoms. I had them in the grocery store yesterday, but only for a short time. They say I'm neurologically fine...I don't have the education to even begin to argue with them.


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## Visual (Oct 13, 2010)

It is always good that doctors don't find major neurological issues. The hard part is the tiny stuff and the thin line between neurological and psychological. One just has to try thing and live as positive as they can.


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