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Thanks to the magic of Google image search, we can get the full context on these photos. It isn't surprising that @smac97 chose to take the photos out of context, because, unsurprisingly, the full context doesn't support the point he is trying to make. In May of 2025, Lily Tino went to Disney World to make a series of videos ranking the Disney World's restrooms. That seems quite tacky to me, but social media. The behavior that is objectionable here is that in some of the videos, she captured videos of people in the background inside the restroom. That is what's objectionable here--not whether the person's birth certificate has an F or an M in the box. This is an image of Paul Bixler. "Bixler has had a decades-long, illustrious career in public education, ranging from teacher to administrator to principal. She decided to come out of retirement in 2020 to run for an open school board seat at Liberty Elementary after seeing turnover and turmoil around the pandemic, hoping to help." Paul was a genuine asset to her community, and was embraced by everyone around her. But she became the target of a hate campaign not because of her work for the community, but because right wing politicians and their tools thought she was a useful target. Her story can be read here: 12News: 'This is not a choice. I do not choose to be transgender': West Valley school board member becomes target of harassment This individual claims to be inter-sex. In the first video, she went into a public restroom in a public building, peed, and left. Nicole Gillis, the chair of a right-wing student organization saw this. Rather than calling the cops out of any belief in a possible crime or danger, she took out her phone to record a video of her confrontation with the person as they left. When she left, Nicole shoved a camera in her face and said, "Excuse me, what were you doing in the women's bathroom?" She replies, "I'm sorry?" "What were you doing in the women's bathroom?" "I was peeing." In the second video." she went into the bathroom at McDonald's, with permission from that establishment. She peed, and washed her hands and left. She was the only one in the restroom. There was no allegations of peeping into stalls, exposing, photographing anyone, molesting anyone, or targeting children. While she was peeing, an angry Christian man decided to set up a video camera so he could record the confrontation he was planning when she walked out. As she was leaving, the Christian soldier angrily confronts her in the most judgmental and anti-Christian tone imaginable. The Christian triumphantly tells her, "God will take care of you in the end!" For the sin of peeing in a toilet that this other guy disagrees with. Yea. That sounds like what Jesus would say. The amount of hate this stirs up in people is fascinating, and this is a great example of what's really going on here. If you made a list of problems in the world, an inter-sex individual who identifies as a woman using the toilet in the women's restroom rather than the men's is a tiny issue. At best. It is so clear that the point of this is to distract and manipulate voters. On the left is Dawn Ennis, a successful journalist is who famous for being fired by ABC in 2013 for coming out as Transgender. She was on assignment from Forbes and the Los Angeles Blade to cover a swim meet at the McAuley Aquatic Center at Georgia Tech. On the right is Kellie-Jay Keen-Minshull, a full-time professional anti-transgender activist. Keen-Minshull flew from England to Atlanta to protest an NCAA swimming event. The only evidence we have that Dawn Ennis has ever used a lady's restroom is the fact that people like Kellie-Jay confront her in public and ask the loaded question, "I want to ask you for the safety of women and girls, do you use women's spaces?" As if which toilet she uses has anything to do with "the safety of women and girls." The photo above is from Kellie-Jay stopping Dawn Ennis in a hallway at a swim event to ask that question and hopefully get a viral video out of it. If you'd like to help Kellie-Jay make more money by harassing transgender people than she already does, you can donate here: https://www.letwomenspeak.org/ You can read the full story of this interaction here: https://www.losangelesblade.com/2022/03/20/terfs-challenge-reporters-gender-at-ncaa-womens-championship/ Let's expand the examples of transgender hate to Peru. In the dress on the right is 42-year old Walter Solís Calero. Walter dressed up as a school girl and snuck into the girls restroom at a school for perverted purposes. A girl saw him and screamed. The Assistant principal called the cops and the rest is history. Walter isn't transgender and never claimed to be a woman, nor claimed to have the right to be in the girl's bathroom. He was a male pervert pretending to be a girl so that he could sneak into the restroom for voyeuristic purposes. A heterosexual pervert sneaking into the girls room to see girls is categorically different than a transexual going into the restroom to pee. It seems Smac's fear is that a pervert could play the I'm-really-a-woman-and-I-have-the-right-to-be-here card, but there have been zero examples of that happening. Anywhere. Ever. This is Brandon Awogboro, a convicted Level 2 sex offender. He was caught hiding in a woman's bathroom and spying on a woman in another stall. Brandon never claimed to "be a woman" or otherwise having a legitimate right to be in the restroom. Again, a male, heterosexual pervert hiding in a bathroom stall is categorically different than a transgender individual going to the restroom to pee. This is Anthony Roy Adams. He was drunk and found himself at a WalMart in a town that was different than where he thought he was. In his drunken stupor, he stumbled into the women's restroom, not knowing what he was. While he was arrested "in the women's bathroom", the charge was public drunkenness. Again, Adams never claimed to be a woman or claimed to have some sort of entitlement to be in the women's room. There is no evidence that he was spying, exposing himself, or otherwise assaulting anybody. Again, this is categorically different than a transgender individual needing to pee and making his or her own decision about which public toilet would be most appropriate. This one is genuinely funny. It was posted on Instagram by comedian DeStorm Power on February 23, 2024. Here is what happens. A man takes out his phone and video tapes his daughter walking into a restroom at a park. He says "You make sure nobody's in there!" He pokes his head in and starts videotaping into the women's restroom. He yells out "Hello!" Right on cue, the man in the headphones pictured above walks out from around the corner, smiling. DeStorm says, "See! There's a man in there!" The guy in the headphone dries his hands and walks away smiling while the man recording the video says, "Hey! That's the women's bathroom!" Then, the man with the camera walks all the way into the woman's bathroom, still recording, and pushes open all of the stalls, recording what he finds inside. He says, "You got to go in with your kids, make sure there ain't no man in the damn bathroom!" It boggles my mind that not everybody sees how this was obviously staged and is satire. And I think this is the perfect metaphor for this whole conversation. It isn't serious. Here is my summary of the videos: The one transgender person who did anything actually wrong in the restroom was the first one, who videotaped herself in the restroom and caught other people in the background. That was wrong, but the wrongness was their stupidity trying to be an influencer and had nothing to do with being transgender. Other than that, the transgender people were just going about their lives and were being pretty viciously attacked by judgemental Christians for which toilet they used, without even any accusations of doing anything wrong beyond that. Other than the one exception above, the people who did actual things that were wrong were all heterosexual, cis men who never pretended to be transgender and never asserted any right to be in the lady's room. In context, Smac's own photographs show how this is a non-issue. Nobody is getting away with anything that is threatening or otherwise posing a danger by saying, "I have a right to be here because I say so!" Smac still hasn't provided a single example of a bad actor trying to harm someone under the guise of having a right to be in the restroom. Other than the cis-men Smac tries to associate with transgender people, if there is anything dangerous going on, it is by so-called Christians trying to stir hate against and provoke fights with people they don't approve of. The limiting principle should be this: if you need to go to the bathroom, go in to the one you think is most appropriate, take care of your business, and leave. That is what civilized people have been doing since sex-distinct bathrooms have existed, and there is no evidence that this is no longer working.

Good voices and harmonies. If there are a number of LDS missionaries who can sing as well as this, then I think more recent chart music would be improved, in my opinion that is. ✨👍

Inspired by another post by @theplains, seeing a tangent, I thought perhaps it deserves its own thread. Because this is very important, as its one of the roots of the disagreement. When critics engage Latter-day Saint theology regarding the Council of Gods, Exaltation, or the distinct Beings of the Father and the Son (and sometimes Creation from Material), they frequently point to Isaiah’s Denial Verses but often called by scholars as the Incomparability Statements of Deutero-Isaiah. "I am the Lord, and there is none else, there is no God beside me..." (Isaiah 45:5) "Is there a God beside me? yea, there is no God; I know not any." (Isaiah 44:8) In modern Christian theology, these verses are routinely cited as absolute ontological proof of strict monotheism, the idea that literally no other divine beings exist in the universe in any sense. However, above these theologians are scholars of the Ancient Near East, we would say most notably the late Dr. Michael Heiser, and also Latter-day Saint scholars, that highlight that modern reading misses the Hebrew rhetorical idiom. Comparative Incomparability of Isaiah about Babylon & Nineveh The key to understanding this idiom is looking at how Isaiah and contemporary prophets like Zephaniah uses the exact same Hebrew phrasing to describe other entities Babylon in Isaiah 47:8 "I am, and none else beside me; I shall not sit as a widow..." Nineveh in Zephaniah 2:15, "This is the rejoicing city... that said in her heart, I am, and there is none else beside me..." It is a claim that the city is without equal, not that other cities don't exist. When Nineveh or Babylon claim "there is none else," the author obviously does not intend to state that no other cities exist on Earth. It is a hyperbolic idiom of unrivaled preeminence and peerlessness, not spatial or numerical solitude. The only reason we are seeing monotheism is if we strictly view them through a post-Enlightenment ontological len. Heiser and most any ANE scholars demonstrated that Yahweh is an elohim, but so are the beings in His Heavenly Council (angels, bene elohim, holy ones). When Yahweh says, "there is no God beside me," He is not asserting that He is alone in His council in heaven. Doing so creates severe internal contradictions when set against passages like Deuteronomy 32 and Psalms.1. Reading Strict Monotheism into Isaiah Collides with Deuteronomy 32 and Psalms 82 If Isaiah’s statements were meant as strict, absolute monotheism, the Old Testament canon becomes fundamentally self-contradictory. Deuteronomy 32:8–9, in the Dead Sea Scrolls and Septuagint, "When the Most High [Elyon] gave to the nations their inheritance... he set the boundaries of the peoples according to the number of the sons of God [Bene Elohim]". El Elyon allocates governance of the nations to lower divine beings, and Yahweh receives Israel as His inheritance from Elyon. Psalm 82 & Psalm 89 Psalm 82:1 states that Yahweh "judgeth among the gods [elohim]" in the divine council. Psalm 89:6 asks, "Who in the heaven can be compared unto the Lord? who among the sons of the mighty [bene Elim] can be likened unto the Lord?" The incomparable elim are presumed to exist. The elohim of Psalm 82 are not humans Firstly, the inheritance connection to Deuteronomy 32, Deuteronomy 32 is the backdrop of Psalm 82. As the Lord has not yet "inherited" all the nations. "Arise, O God, judge the earth: for thou shalt inherit all nations." (Psalm 82:8) Human magistrates in Israel were given jurisdiction over matters within the borders of Israel. Israelite judges were never assigned to govern or "inherit" Egypt, Babylon, Assyria, or Philistia. Psalm 82:8 directly mirrors Deuteronomy 32:8–9, where Yahweh originally divided the non-Israelite nations among the bene elohim (sons of God) as an inheritance. In Psalm 82, because those divine rulers governed corruptly, Yahweh called upon by the psalmist to strip them of their authority and reclaim their inheritance over all the nations of the earth. Human judges in Israel never held that worldwide territorial mandate in the first place. Secondly, the assembly of elohim are in heaven. Psalm 89:5-7 eliminates any ambiguity. "Let the heavens praise your wonders, O LORD, your faithfulness in the assembly of the holy ones. For who in the clouds [ba-shahaq] can be compared to the LORD? Who among the gods is like the LORD, a God greatly to be feared in the council of the holy ones, and awesome above all who are around him?" Psalm 89 rules out the notion that Yahweh’s council of sons of God refers to an assembly of humans because it explicitly places that council "in the clouds." There is no text that suggests that there are a group of human judges in the heavens ruling with Yahweh over the nations. That position is only being offered because of a perceived threat to monotheism. Thirdly, Heiser frequently emphasized the irony of Psalm 82:6–7, "I have said, Ye are gods [elohim]; and all of you are children of the most High [bene Elyon]. But ye shall die like men..." It makes no sense for humans. If Yahweh is talking to mortal human judges, telling them "You will die like men" is completely redundant. Human judges already die like men, mortality is the natural state. A true condemnation is telling a divine, immortal elohim that they will be stripped of their divine status and condemned to a mortal death is an actual sentence of judgment. Isaiah Venerates El Elyon Old Testament scholar Margaret Barker argues extensively that Isaiah laments the purge of the First Temple, specifically the removal of the Heavenly Mother (Asherah) and the divine council during the reforms. The pre-exilic First Temple religion venerated El Elyon, His Son Yahweh, and Asherah. Isaiah uses the title in the famous lament over Lucifer/Hilel, Isaiah uses Elyon precisely in contexts involving the Divine Council, the "mount of the congregation". Ugaritic texts discovered in 1929, the gods gathered on Mount Zaphon, the abode of their cheif God, El, father of Baal-Hadad. In ancient Canaan, because Mount Zaphon was to the far north, the proper noun Zaphon literally became the Hebrew word for "North". Isaiah 14:13–14, the rebel boasts, "I will ascend into heaven, I will exalt my throne above the stars of God [El]: I will sit also upon the mount of the congregation [Har Mo'ed], in the reaches [yarketei / mount] of the north [Zaphon]; I will ascend above the heights of the clouds; I will be like the Most High [Elyon]." Isaiah Venerates Asherah Great Isaiah Scroll (1QIsa) from Qumran of Isaiah 7:11 has a one letter difference. Masoretic Text says "Ask a sign for yourself from [me'im] the LORD your God..." The Great Isaiah Scroll (1QIsa) says, “Ask a sign for yourself from the Mother of [me'em] the LORD your God..." Instead of Isaiah telling King Ahaz to ask for a sign from the Lord, the verse asks him to request a sign from the Mother of the Lord. If Ahaz is told in 7:11 to ask a sign of the Mother of Yahweh, then when the prophet declares in 7:14, "Behold, The Virgin ['almah] shall conceive," is the Mother of the Lord herself. Asherah will bring forth the Immanuel, meaning a royal Davidic child (Isaiah 8). In royal Near Eastern mythologies such as at Ugarit, their goddess figure was a "Virgin" and the "Mother" of the kings. My Disagreement with Hieser, elohim is a noun applied to many other beings, but not a noun for ordinary beings Heiser's view treats elohim as a realm identifier (anyone living in the spirit realm is an elohim). I have a counter-argument that elohim is an adopted family/lineage title. Through a covenant, like the priesthood, certain beings, whether prophets, high priests, angels, or angelic localized territorial guardians are adopted into the genos (lineage/family) of El. Instead of a natural spatial status, elohim reflects a covenantal promotion. Human prophets like Samuel or Moses (Exodus 7:1) and divine messengers become elohim through the bestowal of Yahweh's authority, name, and often identifiable by priestly garments. 1 Samuel 28:13–14, when the medium of Endor cries out that she sees an elohim ascending from the earth, Saul asks, "What form is he of?" She replies, "An old man cometh up; and he is covered with a mantle [me'il]." The me'il was the explicit garment of priestly and royal authority (Exodus 28:31, 1 Samuel 2:19, 15:27). Samuel always wore a priestly coat since he was a child. Samuel is identified by the medium as an elohim because he wearing mantle of priests/gods, as he retained his identity beyond the veil. He is not an elohim simply because he is a ghost in the underworld; he is an elohim because he is still a priestly son of God and identified by his robe of a god. To truly be adopted by Christ, Born Again, is actually to become a god, because that's what being a true son of God means. Heiser argues that the fallen bene elohim (the territorial powers who rebelled) are sentenced to fall (Psalm 82:6–7). But redeemed humans are adopted as new sons of God through Christ, literally take their vacant seats in the divine council to rule with Jesus (1 Cor 6:3, Rev 2:26–27). LDS theology mirrors this concept of exaltation, 2 Peter 1:4 "partakers of the divine nature" and Romans 8:17 "joint-heirs with Christ". Salvation alters a human's dynamic status, elevating them as literal family members rather than remaining lower-tier subjects. You can believe as you wish. It's just hoped you understand the argument before rejecting it.

I'm sure you think Fauci is a beautiful human being. It was proper for him to fund "gain of function" lab work in Wuhan, red china. </sarcasm> "at all" ? Why the absolutes?

Possibly. Another possibility is the sad fact that gabepentin loses effectiveness for many over time and what might look like augmentation is simply return of symptoms, unlike the dopamine agonists that increase symptoms from the original baseline. There is a difference between a med slowly not working and so upping the dose to try to get the same relief and the drug making symptoms worse so one increases it, compounding the problem. Also note it’s a pediatric case. That rate for adults is much lower than for the dopamine agonists (given in an above study), but I did overstate that there was no augmentation. Good you corrected me. Thank you, Most people revert to pretreatment levels with the dopamine agonists after a few weeks, though it may be more gradual, thankfully. However some won’t completely reverse. Can be hard to tell because the disorder is progressive. I suspect mine had a substantial increase that wasn’t resolved given the dramatic difference between the increase over the 3-4 years I was on them vs the 25 years I have been on the other drug (RLS never increased for ten years based on no change in meds and has decreased some the last ten years). I know I am not the only one with permanent significant effects because of the group I was in, but I am grateful that I am atypical at least in this way. But thanks for bringing this study to my notice. It appears to be new, so may end up with other studies countering the usual explanation. Gabapentin has been used much more extensively in general than the dopamine agonists, so there’s some related data that’s been available through that already. I don’t know the extent of RLS studies on Gabapentin to know if the issue is not enough cases of long term use, I will be rather surprised if it is, but will research it before making any conclusion.

No, because they aren't "recommendations of actual doctors". This is ONE doctor that already admits short-term efficacy of dopamine agonists while simultaneously ignoring the negative short and long-term effects of his own proposal. Why are you even bothering bringing up nicotine, alcohol, etc.? Quitting those are already default considerations in pretty much any condition. You can see augmentation issues with GABA analogs. https://academic.oup.com/sleep/article/48/Supplement_1/A625/8135982?login=false "Occurrence of symptoms earlier in the day with increasing severity suggested augmentation. " "This case highlights a fairly underreported phenomenon of gabapentin-induced augmentation in pediatric RLS." So it looks like lower rates are more the product of a lack of sufficient data. Again, read my initial statement. The only one trying to bring in long-term problems with dopamine is you. Which is worse? Augmentation due to long-term use of dopamine agonists or the 40% increased risk of suicide associated with long-term GABA analog use? Hard to study long-term effects if your patients are offing themselves before you get a chance.

Again, you are dismissing the experts for your personal theory. Your choice. I will rely on the experts. The rest of your post is ignoring quite a bit of what I said, removing context, etc. Not worth any more effort. Don’t know how you came up with this stuff. Don’t want to know…which surprises me. I always want to know. Everyone observing, if you are seriously interested in RLS, don’t take my comments as doctrine. Just ignore BlipBlap on this subject. (I don’t think I have ever said that before on the board) RLS Foundation is a good first stop with the easiest to remember and type address (I so miss the days of LDS.org) https://www.rls.org also John Hopkins https://www.hopkinsmedicine.org/neurology-neurosurgery/specialty-areas/restless-legs-syndrome Mayo or Cleveland Clinic if you want less reading. Sorry for the detail and my too many posts due to my semi obsession with accuracy. I wouldn’t have hopped down this rabbit trail if I knew it would be mud all the way down with a disappointing view at the end.

So you are ignoring the recommendations of actual doctors and researchers based on real life responses to depend on an out dated oversimplification of the process involved? It gets complicated because dopamine both inhibits and excites. Then there are the negative side effects of long term use of dopamine agonists, especially augmentation, but also other effects, like compulsive behaviour, nausea, vomiting, dizziness and sedation, which has led to preferring Gabepentin and pregabalin as first line even if not as targeted. They don’t work for me, but Horizant and Gralise work well for my daughter. Her doctors, specialists in sleep and pain, have never suggested using the dopamine agonists. She started treatment probably 15 years later than I did, but had the same problem with doctors not listening and insisting on using drugs not recommended for those with the disorder (she went from waking up around 10 am to waking up around 2 pm, which defeated the purpose of the medication to help with her severe social anxiety and get her back into school). I warned the doctor, he stated he didn’t treat RLS and we were so desperate for our daughter to have some semblance of a normal life again (diabetes type 1 sent her anxiety through the roof, wasn’t great for RLS either, but besides sleeping later, it wasn’t a huge issue until after the psychiatrist refused to listen and we were too dismissive of our own knowledge and experience). BTW, the current model of RLS isn’t dopamine deficiency. It’s a complicated interaction of altered dopamine regulation, iron-dependent dopamine biology, circadian effects, and interactions among several neural systems. It’s not a straight forward drug in, increased dopamine, less RLS process. First line treatment after establishing it is RLS and removing any drugs that may be triggering it is more likely to be test iron and address and deficiency, but that’s difficult at times if people can’t tolerate iron supplements and don’t qualify for iron infusions, which are quite expensive. Lifestyle recommendations like exercise, reducing or quitting nicotine, alcohol and caffeine, sleep hygiene, and a couple of other things I can’t remember should be suggested as well. If someone is interested in supplements, magnesium has the best documentation. Then if medication is still needed, first choices are three α2δ calcium-channel ligands: Gabapentin, Pregabalin, and Gabapentin enacarbil. Horizant is the last and Gralise is an extended release that delays it for the small intestine. Horizant gave me ten days of pure relief, then stopped working. No vomiting or compulsive behaviour or augmentation thank goodness. So much better than the agonists. But it works great for my daughter. We react very differently to drugs. You don’t get augmentation with the Gabepentin versions, you do for a high percentage of the agonists according to documentation. I am not an exception. The experts working over years with patients knew this and were recommending against the use 20 years ago before I even started on any drugs. It is foolish to use a drug that is likely to make a disorder worse, not better. https://www.neurologyadvisor.com/features/restless-leg-syndrome-aasm-guidelines-update/ Your risk of augmentation increases the longer you are on it. https://pure.johnshopkins.edu/en/publications/a-10-year-longitudinal-assessment-of-dopamine-agonists-and-methad-4/

The law explicitly bans proselytizing outside specific areas. There have been cases where evangelical Protestants have been prosecuted under the law for talking to people about their faiths inside their own homes and Jehovah's Witnesses have been banned from the country entirely. It is most definitely religious in nature and has nothing to do with Putin in terms of whether someone is opposed to him or not.

The HHS is now so politicized I don’t trust their report at all. It has regularly been spouting nonsense for the last two years about all kinds of quackery. Why should I believe them now?

Sure, but that would still make it a "monoamine problem". It would still make far more sense to use it instead of GABA analogs given the general inhibitory effect of GABA versus dopamine's inhibition of norepi/noradrenaline only.

I’m not even sure this had a religious motivation. It might help to know if they are going after others even vaguely involved with Putin’s opposition.

...Insomnia would obviously be a sleep disorder as it indicates that you can't sleep. That's a massively poor attempt at a counter. Would you call paralysis something other than a movement disorder because you aren't moving? What do you think "disorder" means? RLS isn't a "sleep disorder" because the movements involved can occur whether you're awake or asleep. Hence it being a "movement disorder". It wouldn't even be "sleep-related" for the same reason. You could have the problem while being wide awake and sitting in a cramped space for extended periods of time, like on an airplane. Presumably you could also have it in other instances too, like standing in a military-style formation (be it in the actual military or something like marching band) for example. You don't have to meet all diagnostic criteria in order to be accurately diagnosed with something, and seeing as how in your initial post on the subject you stated the following: "I told doctors I was sleeping 16 hours a day, no sleep test offered. I told them 20 years later I was sleeping 30 minutes at a time a couple of times a day." Doesn't sound like a sleep disorder at all. It sounds at best like depression. I don't recall saying that dopamine agonists were first-line, but neither of your links suggest that they shouldn't be. Oddly enough, your first link goes along with what I said: "Although dopamine agonists (DAs) have excellent short-term efficacy for RLS patients and relatively few side effects, Winkelman says, they are also associated with a long-term overall worsening of RLS symptoms," Now, compare that to my statement: "I'd just give you a low-dose dopamine agonist and reevaluate in 6-ish weeks." 6 weeks isn't' "long-term". All your second link is is a rehashing of the first. It cites the same doctor's work. Now given that GABA is an inhibitory neurotransmitter, it does make sense for RLS. Ironically enough though, about a third of the people on GABA analogs experience...psychiatric depression. There's also the other problems, but I'm sure they're nothing too bad. Oh. https://web.archive.org/web/20191222091828/https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-breathing-problems-seizure-and-nerve-pain-medicines-gabapentin-neurontin Well I suppose that your RLS will be fixed if you stop breathing. Seeing as how you're articles touch on what happens if people miss dopamine agonist doses, I wonder what happens if people miss their doses of GABA analogs. Insomnia Confusion Suicidal ideations So yeah, it doesn't look like dopamine agonists being first or second line treatment is "outdated". You're confusing practice with theory, and using GABA analogs is still most definitely theory in this case. I already explained the connection between RLS and depression.

It would be more accurate to describe as possibly a dopamine dysfunction, involving altered dopamine signaling and regulation. Not all forms of RLS have been able to be linked to dopamine yet, but I wouldn’t be surprised if it ended up involved in some fashion.

It’s old (85) But was in clinical psych when first when getting the depression diagnosis, within 5 years for most of them, 8 years the last time. Not that hard to remember diagnostic criteria for depression and share that with the doctors. These are the current ones, would have to check, but assuming they are more thorough now, so will just use these. The 9 Diagnostic Symptoms Depressed mood: Feeling sad, empty, or hopeless most of the day. Me from age 22-42 (or whenever I got put on the dopamine agonist that rewired my brain so to speak): nope, definitely not Loss of interest: Little to no pleasure in all or almost all activities (anhedonia). Me: nope, definitely not. Weight or appetite changes: Big weight loss (not dieting) or weight gain, or big change in appetite. Me: only when put on antidepressant drugs (gained 5 lbs in a couple of weeks with all of them) or pregnant. Sleep changes: Trouble sleeping (insomnia) or sleeping way too much (hypersomnia). Me: massively both, hours to go to sleep, 12-16 hours once asleep if not woken up. Physical movement changes: Feeling overly restless or noticeably slowed down to others. Me: restless at times (duh) Fatigue: Tiredness or loss of energy nearly every day. Me: lots and lots of fatigue Worthlessness: Feeling worthless or having heavy, unneeded guilt. Me: nope, not at all, some frustration though Concentration trouble: Trouble thinking, focusing, or making choices. Me: nope, not at all Suicidal thoughts: Recurrent thoughts of death, thinking about suicide, or a suicide plan. [1, 2] Me: once, due to a drug, very scary, never took the drug again So explain to me why they went to depression instead of sleep issues? Heh, maybe because their training in sleep issues was minimal. Not their fault, just the way it was set up, but why not send me to a specialist instead of arguing with me I was depressed? “How can I be depressed when I am happy, in a good mood, enjoying university, have the best kid in the world and a sweet, noncritical husband, and having fun with my family?” Not saying they were negligent in not discovering my RLS. They were negligent for focusing on depression when I lacked the most obvious mood dysfunctions and only had sleep related issues. They should have focused on sleep. ——- I am well aware of how serotonin, dopamine, and norepinephrine interact with deficiencies or imbalances leading to a large variety of not nice stuff. Well aware dopamine is involved with some forms of RLS. Still undetermined if all as there are quite a few varieties, mine is a combo of genetic, iron-related, medication-associated, pregnancy-associated and possibly trauma as I was in a car accident at thirteen and my head crashed against the dashboard. I studied dopamine deeply when looking for alternatives to the Parkinson drugs that were driving me insane. Iron is tested because it’s indicated for dopamine synthesis. Please explain the connection between depression and RLS as you see it. Always interested in learning. I am assuming it’s more than just dopamine is involved.

And I would have a very good case for malpractice. Btw, you are out of date. Dopamine agonists are no longer the first line choice for long term treatment. While it was Sinemet that took my disorder in 3 weeks from primarily nighttime moderate, occasionally severe to all day every day severe with the bugs just moving in rather than visiting from time to time, the agonists just kept digging it down deeper and added nausea, vomiting, compulsive eating, migraines and chronic low level depression (emotionally numb, no lows but no highs, life like a treadmill, living in bubble wrap). https://sleepreviewmag.com/sleep-treatments/pharmaceuticals/prescription-drugs/restless-legs-syndrome-dopamine-agonists/ https://www.health.harvard.edu/diseases-and-conditions/a-major-change-for-restless-legs-treatment Tried all three as well as pergolide. Fun times. I would be out looking for another doctor before you finished typing your treatment protocol into my file. Ever heard of augmentation? projectile vomiting? That would be a horrendously obvious case of a doctor refusing to listen to his patient. Had one of those, so I know it’s possible. I went back to the guy who gave me my second sleep study…or was it the third? and had to beg him to take me on. I had been passed to the disaster doc when my neurologist who found my best solution moved out of town and she hated the opioids and just pretended me sleeping only for a few hours during the day on the drug she was comfortable with was reasonable after assuring me she was going to work with me no matter what to give me back a decent routine. She gave up after three tries with different drugs. I am a difficult case, but easy patient according to most of my doctors. I am good friends with a couple of them.

Wow. Okay…do you see insomnia as not a sleep disorder for the same reason…it doesn’t occur when you are asleep, only awake. Do you believe a sleep study is pointless for insomnia? RLS is technically defined as a sleep disorder because it interferes with sleep. RLS is technically a movement disorder because it affects movement. RLS is a neurological disorder because there is something dysfunctional in the nervous system. Guess what, it can fall into all three categories at once. I personally prefer “sleep-related neurological sensorimotor disorder” myself. Hits all relevant major categories at once, A disorder can belong in more than one category at a time, And btw, it’s not just “often” happening while you are awake, probably it is “only” as it is defined as sensations experienced while conscious delaying or preventing sleep.*** Of course, that includes being half or barely conscious, but your brainwaves probably wouldn’t show in a solid sleep cycle yet. At most fluctuating between alpha and theta (think that’s waking and light sleep, been awhile, so could be wrong on the label). Everyone I have heard describing them said it was preventing them from sleeping. Never mentioned they felt them while sleeping. I don’t feel it when I am partially awake and just drifting. I can think to myself hey, great, no RLS, I will be able to go back to sleep easily and the next minute it’s there because I focused on it. That is something I should research. Though I have dreamed talking about the sensations at times, I have never had a trying to find relief for RLS dream like I have had trying to find a restroom with a functional toilet dream when I have been asleep with a after drinking significant water. Pretty sure it was the PLMD that was throwing me out of my bed. That’s what pushes the blankets and pillows on the floor, tears holes in the sheets, and has my head off the side or down at the bottom instead of the top. RLS makes me twitch and scratch and then give up and bang my body against the wall or just rock and rock with loud music with a strong, consistent drum beat. Oh, and kick people who just lightly touch me. I actually hit someone once too, but generally it’s my legs that are trigger happy. Restless legs is not the movements, but the sensations nor does it directly/automatically cause the movements. My mother who had an occasional mild form of it found if she held herself still resisting the urge to move, it passed faster. For me, it made it worse, but I got my dad’s version (I don’t know if her dad had it, her mom didn’t, so it may not have been the vicious genetic version I got from dad). It’s the hoping for relief that causes the movements. Can be so intense, not moving is painful. PLMD is directly movement, the moving around in bed while asleep, otoh. They can get confused because so many with RLS have PLMD, but not the same. I have said 24/7 in describing my RLS, you made me think about this and maybe I need to switch it to 18-20/7 for precision.

Right, so if you have a psych degree, you should be familiar with the monoamine hypothesis for depression. Since you didn't make the connection between my initial comment regarding the similarity RLS has to depression, I'm going to go out on a limb and say that your degree didn't actually got into the physiology or it's very much out of date.

Distinction without a difference. The point is that you didn't natively know it and had to consult material outside yourself, hence the term "looking it up". You had to look up the doctor who eventually gave it to you, yes? Note that I didn't say that that sleep study was entirely useless, just pointless. As I asked before, why would I bother ordering a sleep study on something that isn't a sleep disorder? If insurance companies are supposedly making it unprofitable to listen to your patients, why are you acting like ordering superfluous tests that will cost you more as a patient is somehow a good thing? If you come to me with RLS, I'm not going to order all that. I'd just give you a low-dose dopamine agonist and reevaluate in 6-ish weeks.

Again, why would a sleep study be particularly relevant to RLS when it isn't a sleep disorder and can often occur when awake? It's a movement disorder like Parkinson's.

Monoamine problem. In the case of RLS, a deficiency of the neurotransmitter dopamine.

Sorry to observers, please ignore… Who told you this? Please explain in detail your reasoning for this conclusion.

This is still making me laugh. How often do you do this kind of thing? Back between 97-05 when I was getting shuffled between doctors because they finally knew it wasn’t hypochondria after all, but weren’t comfortable drawing outside the very limited lines that were available to GPs and sleep specialists on it at that time, at least in Canada (at least the Canadians never treated it as depression, by then I had got the Chronic Fatigue label which was a step in the right direction). I would last 2 or 3 appointments and then get pointed in the direction of the next specialist. At that time a couple of these doctors assumed I was a medical professional (I used the correct terms in the correct way, was able to anticipate protocol suggestions and discuss with them why and why not for certain treatments, etc). Two said I was much better informed than they were and I know they weren’t just being nice because they were asking my advice of where they should go find the info. And one discussed with me in detail what his then experimental treatment he was thinking might be useful for rls and why and if he could use me to test it. I let him know it probably wouldn’t be that effective (more hinted as I didn’t want to discourage him from trying to find something that worked), but fun to try. That lasted a few times until he went to a conference and heard from the experts that I was right about the likely effectiveness. He then passed me on to a neurologist and that sleep study had that doctor telling me I ran a marathon every night….on the drug, which was validating, but disappointing because I wasn’t given any other option with his apology even though he knew there was one that worked for me (all the doctors knew, but Canada apparently said no…and I understand why). Still no questioning on the doctor’s part that maybe their preferred drug was actually making it worse like I said it was likely going to based on the experts and my experience with the first two versions. I am grateful that the US was much more careless (seems like another all or nothing case, selfishly yay! for stupidity working in my favor for once, tragic that many others have died because they shouldn’t have gotten the drug at least in the manner they did. I don’t think I could have lasted without the change to the med that doesn’t make things bearable at the cost of long term making it worst as too many things were breaking down due to the nightly trauma. Been going to the same doc for sleep for 20+ years now. We talk about the conferences he attends and research we both do, shares insights from other patients, and I used to let him experiment me with the latest thing. Nothing else has worked though and now with my fibro, experimenting is too costly. But please, tell me what I don’t know about RLS and the half dozen or more sleep studies I have been involved with over the years from various doctors once rls became known. 😛

Or because it’s expensive and time consuming to do it right (you have get wired up in a lab, head and legs…or at least they used to, haven’t had one for 15 years) and with a chance of it failing due to…lack of sleep. My daughter had a traumatic experience because the nurses would come in and scold her for not falling asleep…like that’s helpful telling a kid they will cause trouble if the can’t fall asleep in a strange room and bed all tangled up with wires? I finally went out and got her melatonin which she never used as too sedating and therefore that test provided very limited info, but they got to check the check boxes and not have to have the expense of booking her for another night. If she hadn’t slept, insurance wouldn’t have paid for it and the clinic would have had to swallow the loss. If we tried it again and it again didn’t work, we would have had to pay for it, so no more lab studies for her.

No, I wasn’t depressed and specifically told different doctors I wasn’t depressed and why they should not assume that (I have a psych degree, I know the signs of depression and let them know they were missing except for sleep disturbances). The only sleep symptoms they asked about and responded to for more details was how long I slept, when I fell asleep and woke up and if I fell asleep unexpectedly (it took hours to get to sleep). And once the first doctor wrote depression, no one questioned it until I insisted it was flat out wrong (with expert medical documentation describing protocol for diagnosis and treatment and presented it very diplomatically as I used to hate disagreeing with people) …and got ignored (I watched her eyes during the appointment expecting her to turn to the document to at least read what it was and where I got ot from. She never even looked at the file, but looked at my face the full appointment, leaning forward conveying attentiveness, speaking in her reassuring tone as if she was actuakiy listening to me instead of running through her routine…which was probably very useful much of the time as it was my first and only complaint I had of her…and then dropped by my doctor.